Publications by authors named "Michael Yen"

Purpose: To determine the pre-operative, peri-operative, or post-operative risk factors that contribute to pediatric frontalis sling infection or exposure.

Methods: Retrospective study of 193 eyelids that underwent silicone-rod frontalis sling surgery at a single institution between 2014 and 2019.

Results: A total of 222 eyelids were originally identified.

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Article Synopsis
  • The study aimed to identify and evaluate factors that contribute to the failure of ptosis repair surgeries, specifically comparing two surgical methods: external levator advancement/resection (ELR) and Müller muscle conjunctival resection (MMCR).
  • A total of 240 patients were analyzed, revealing that 90% of eyelids achieved success after MMCR compared to 79% after ELR, with MMCR showing significantly better long-term outcomes.
  • Key risk factors for surgical failure included chronic use of topical prostaglandins and corticosteroids, lower preoperative margins, prior eye surgeries, and younger age, with the use of topical prostaglandins being identified as the highest risk factor.
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A 74-year-old man with a history of chronic lymphocytic leukemia (CLL) presented with large salmon-colored patch lesions along the inferior fornix and superotemporal conjunctiva of the OS. The patient underwent an incisional biopsy of the lesions, which showed a CLL with areas of large B-cell lymphoma, consistent with Richter transformation. Following medical and radiation-based therapy of these lesions, the patient returned 3 months later with inferomedial preseptal swelling in the contralateral eye, which biopsy proved to be recurrent/resistant low-grade CLL with a posttreatment extranodal marginal zone B-cell lymphoma pattern.

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Purpose: To review the efficacy and safety of the use of intraoperative image guidance (IIG) in orbital and lacrimal surgery.

Methods: A literature search of the PubMed database was last conducted in November 2023 for English-language original research that assessed the use of any image guidance system in orbital and lacrimal surgery that included at least 5 patients. The search identified 524 articles; 94 were selected for full-text analysis by the panel.

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Article Synopsis
  • A pediatric patient suffered an injury to the upper eyelid caused by a zipper, which was successfully treated in the operating room.
  • The surgical team utilized a double-action bone cutter to cut the zipper's median footplate, freeing the trapped tissue.
  • While zipper injuries are commonly discussed in urology, there is limited documentation on similar cases in ophthalmology, leading to a review of removal techniques and specific considerations for eyelid injuries.
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  • A 67-year-old woman with chronic canaliculitis had surgery to remove a fleshy mass found in her tear duct, which turned out to be a type of lymphoma.
  • During staging, a PET/CT scan showed no signs of the disease spreading, allowing her to choose observation over more aggressive treatment.
  • After 12 months, she is still free of disease symptoms.
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Purpose: To review the literature on the adjuvant use of mitomycin C (MMC) during dacryocystorhinostomy (DCR) in adults with primary nasolacrimal duct obstructions (NLDOs) to determine the efficacy in improving functional and anatomic outcomes with an acceptable level of risk.

Methods: A literature search conducted in November 2020 and updated in November 2022 yielded 137 articles. Twenty-four articles met the inclusion criteria and were rated for level of evidence by the panel methodologist.

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Purpose: Surgical fires pose a substantial risk to patients and can cause significant injury, especially in oculofacial surgery. Ocular surface lubricants can potentially act as fuel for an operating room fire. We present an experimental analysis of the flammability of 9 commonly used ophthalmic lubricants under 4 ignition sources used in oculofacial surgery with and without supplemental oxygen.

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  • Two 12-year-old identical twin sisters presented with similar, painless orbital masses that had gradually increased in size since birth, suspected to be orbital dermoid cysts.
  • They underwent surgery to remove the masses, and histological analysis confirmed the diagnosis of dermoid cysts.
  • While dermoid cysts are typically seen as a random developmental issue, this case suggests that genetics might influence their formation in twins.
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A 23-year-old patient with Williams-Beuren syndrome presented with ocular irritation and bilateral persistent tearing. Despite probing as an infant which showed bilateral nasolacrimal duct obstruction, dacryocystorhinostomy had been avoided due to the patient's syndromic supravalvular stenosis and related anesthesia risk. As the known diminished production of elastin in Williams-Beuren syndrome causes an array of associated vascular diseases, this case report hypothesizes that the lacrimal duct becomes obstructed through a similar mechanism.

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Purpose: To characterize research productivity of ophthalmic plastic and reconstructive surgery (OPRS) fellows during residency.

Methods: A database was compiled of OPRS fellows listed on the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) Annual Fall Scientific Symposium program books who began their fellowship between 2012 and 2019. PubMed was searched for all publications published between July 1st of the year they began residency and September 30th of the year they began fellowship training.

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  • The study aimed to objectively assess the blink rate in patients with blepharospasm receiving botulinum toxin type-A injections by measuring blink rates before and after treatment using slow-motion video.
  • Results showed that blink rates significantly decreased from 39 to 18.5 blinks per minute after treatment, with greater reductions observed in long-term treatment patients.
  • Additionally, self-reported measures of blinking frequency and light sensitivity improved significantly, indicating that botulinum toxin type-A injections effectively alleviate symptoms in blepharospasm patients.
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Introduction: The incidence of ocular injury associated with maxillofacial trauma remains poorly defined, with reported rates ranging from 0.8% to 92%. Our study aims to more accurately characterize ocular injuries associated with midface fractures.

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Purpose: To review the current literature on the safety and efficacy of orbital radiation for the management of thyroid eye disease (TED).

Methods: A literature search was conducted last in February 2021 of the PubMed database to identify all articles published in the English language on original research that assessed the effect of orbital radiation on TED. The search identified 55 articles, and 18 met the inclusion criteria for this assessment.

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Purpose: To review the published literature to determine the efficacy and safety of homeopathic agents or vitamins in reducing ecchymosis after oculofacial surgery or laser surgery.

Methods: A literature search was conducted in the PubMed database initially in December 2019 and updated in March 2020 to identify all studies in the English language literature on the use of homeopathic agents or vitamins in oculofacial procedures, including laser surgery. The search yielded 124 citations, and 11 articles met all inclusion criteria for this assessment.

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