Surgical technique, perioperative management and early outcome data of the PAUL® glaucoma drainage device.

Objectives: To describe a surgical technique and early post-operative outcomes for a novel glaucoma drainage device-the PAUL® glaucoma implant (PGI).

Methods: A consecutive cohort study of subjects who had PGI surgery between February 2019 and May 2020 with a minimum of 6-month follow-up. Primary outcome measures included failure (intraocular pressure (IOP) > 21 mmHg or a <20% reduction of IOP, removal of the implant, further glaucoma intervention or visual loss to no light perception).

Conjunctival bleb compression as a treatment for hypotony post XEN45 implant in uveitic glaucoma.

Purpose: Over-filtration and subsequent hypotony are recognised complications of penetrating glaucoma procedures, especially when augmented with antimetabolites. Patients with uveitis are especially at risk of hypotony and this can reduce the final acuity achieved, compromise surgical outcomes and adversely affect the inflammatory status. The incidence of hypotony following XEN45 implant insertion is higher for uveitic patients and we present a method of surgically addressing this hypotony with transconjunctival compression sutures that are placed over the overdraining XEN45 implant.

Chronic Eyelid Edema Following Periocular Hyaluronic Acid Filler Treatment.

A 54-year-old woman received multiple injections of hyaluronic acid filler to the brow region to address volume loss over a 21-month period. She then developed significant pitting edema of both upper eyelids, which persisted for 6 years. Hyaluronidase (Hyalase) was injected into the subcutaneous brows and resulted in complete resolution of the edema within 2 days.

"Emergency" definitive reconstruction of a necrotising fasciitis thigh debridement defect with a pedicled TRAM flap.

Introduction: Necrotising fasciitis (NF) is a rare, severe, rapidly progressing and life-threatening synergistic infection primarily affecting the superficial fascia. A novel method of definitive and aesthetic reconstruction of NF thigh defects by using a pedicled transverse rectus abdominis myocutaneous (TRAM) flap without recourse to temporising skin grafts is presented.

Presentation Of Case: A 30-year-old parous woman presented in extremis with fulminant NF of her left anteromedial thigh.

An evaluation of incidental metastases to internal mammary lymph nodes detected during microvascular abdominal free flap breast reconstruction.

Background: The significance of internal mammary lymph nodes (IMLNs) encountered during dissection of internal mammary vessels (IMVs) for microvascular free flap breast reconstruction (FFBR) remains uncertain. We report our experience with the opportunistic harvest of IMLNs during FFBR. Therapeutic implications and patient outcomes are explored.

The use of topical vasodilators in microvascular surgery.

Topical vasodilators are widely used in reconstructive microsurgery in order to ameliorate intraoperative vascular spasm (vasospasm) and facilitate microvascular anastomoses. There is, however, a paucity of literature to support or discredit this practice. A survey of current practice in UK Plastic Surgery Departments was therefore undertaken.