Apraxia of eyelid opening: clinical features and therapy.

Purpose: Botulinum toxin injection is the treatment of choice in cases of benign essential blepharospasm. However, about 10% of the patients do not get sufficient effect from this treatment, and many of them have concomitant apraxia of lid opening.

Methods: Over a 3-year period we treated 12 patients.

Outgrowth of cells from human conjunctival explants onto cornea in vitro.

The epithelium was removed from human corneas, and samples of conjunctival tissue were cultured as explants on the denuded corneal surface for 1 and 2 weeks. Cells migrating from the conjunctival explants onto the corneal surface produced a multilayer where cells on the surface generally showed a flattened appearance. The apical membrane of these cells demonstrated villi as well as microplicae.

Retinal hemorrhages and traction forces in vacuum extraction.

The relationship between the traction forces used in 53 clinically indicated vacuum extractions and the incidence and degree of retinal hemorrhages observed in the neonates within 24 hours after birth was examined. A Vacuum Extractor Recorder (Type SF 30, Knick), was used to measure the traction force necessary for delivery of the fetal head. No relationship could be demonstrated between the force time integral and the appearance and grading of retinal bleedings.

Measurements of fetal head compression pressure during bearing down and their relationship to the condition of the newborn.

Fetal head compression pressure (FHCP) and its clinical importance has been investigated in a group of 46 spontaneous births. Measurement of FHCP was facilitated using a compression transducer positioned between the fetal head and the wall of the birth canal. This method not only constitutes a means of quantitating the forces acting directly on the fetal head, but also provides information about the intracranial pressure generated during delivery.

Neonatal retinal hemorrhages and neurobehavior related to tractive force in vacuum extraction.

Fifty clinically indicated vacuum extractions were studied to evaluate a possible relationship between neurobehavioral abnormality, retinal hemorrhages and the tractive force used for delivery. A Vacuum Extractor Recorder (Type SF 30, Knick), was used to measure the forces necessary for delivery of the head. Infants delivered by the use of extensive tractive force showed no greater incidence of neuropathology than those delivered with less tractive force.