Publications by authors named "Paul D Langer"

Article Synopsis
  • The study aimed to analyze trends in ocular trauma from motor vehicle accidents (MVAs) involving the drivers between 2007 and 2014 using national trauma data.
  • Results showed a 25.3% increase in MVA-associated ocular injuries over the eight years, with men representing the majority of cases and orbital floor fractures being the most common type of injury.
  • Although the overall mortality rate was 4.3%, older adults faced higher risks, especially regarding open globe injuries and other severe ocular trauma.
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Article Synopsis
  • Rosai-Dorfman disease (RDD) is a rare condition characterized by non-tender swelling of lymph nodes due to atypical histiocyte proliferation, but it can also appear in unusual forms, such as orbital masses.* -
  • A recent study analyzed five cases of orbital RDD from the past 18 years, focusing on patients aged 12-36 who experienced eye swelling or vision changes; some had pre-existing conditions while others had no systemic signs.* -
  • Histological analysis of the resected orbital masses revealed distinctive features, including atypical histiocytes and a significant positive response to S100 and CD68 immunostaining, with all followed patients remaining disease-free 1 to 15 years post
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Purpose: To analyze the association between emergent surgery status and systemic adverse outcomes in patients undergoing open orbital floor blowout fracture repair.

Methods: This retrospective cohort analysis utilized the 2005-2018 National Surgery Quality Improvement Program (NSQIP) database. Current Procedural Terminology (CPT) codes were used to identify cases with open treatment of orbital floor blowout fractures (21385, 21386, 21387, 21390, 21395).

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A 52-year-old woman presented with a 6-month history of progressive right proptosis associated with intermittent right retrobulbar and facial pain. MRI revealed a heterogeneously enhancing, well-circumscribed, ovoid, soft tissue mass in the intraconal space near the right orbital apex displacing the optic nerve medially. Excisional biopsy established the diagnosis of a schwannoma-perineurioma hybrid peripheral nerve sheath tumor (HPNST).

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A 5-year-old girl presented with a 6-month history of strabismus and painless left proptosis. Magnetic resonance imaging revealed a homogenously enhancing, anterior, superomedial, left orbital mass. Excisional biopsy established the diagnosis of orbital glomangiopericytoma.

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Article Synopsis
  • The study aimed to analyze trends in tennis-related eye injuries over the past 20 years using data from the National Electronic Injury Surveillance System.
  • Approximately 16,000 injuries were identified, primarily affecting males, particularly boys aged 11-15, with most injuries occurring in the spring season.
  • Despite a downward trend in overall injuries, the data highlights a concern for pediatric patients, prompting recommendations for sports goggles to prevent serious visual complications.
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Purpose: The purpose of this study is to report the demographics and risk factors for undergoing primary enucleation in the setting of acute open globe injury (OGI) in the pediatric population in the USA.

Methods: This retrospective, cross-sectional study of pediatric patients with OGIs in the USA between 2002 and 2014 was conducted utilizing data from the National Inpatient Sample Database. Descriptive statistics, chi-square testing, and univariate and multivariable analyses were performed.

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Purpose: To investigate the risk of second primary neoplasms (SPNs) after primary sebaceous carcinoma of the eyelid (SCE).

Methods: Data on patients diagnosed with primary SCE as their first malignancy were extracted from the Surveillance, Epidemiology, and End Results database from 2000 to 2016. Observed-to-expected ratios of SPNs were calculated to estimate standardized incidence ratios (SIRs).

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Purpose: To evaluate demographic trends of open globe injuries (OGIs) using a large dataset representative of United States population.

Methods: Retrospective cross-sectional observational study using the National Inpatient Sample (NIS) database from 2002 to 2013. Only patients with a primary admitting diagnosis of OGI were included.

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Background: Trauma is the leading cause of enucleations in the USA. Current information regarding open globe injuries (OGI) is based mainly on data from individual tertiary care centers across the country which might skew the findings towards the population served by these level-one trauma centers. The aim of this study is to evaluate the demographics, characteristics, and risk factors of traumatic enucleations in a large data sample.

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A 48-year-old woman presented with a 1-year history of an enlarging, nontender right lateral intrapalpebral mass overlying the insertion of the right lateral rectus muscle, associated with a 3-month history of worsening right orbital pain and retrobulbar headaches. MR imaging revealed an isointense right orbital mass contained entirely within the right lateral rectus muscle and indistinguishable from it. Transconjunctival biopsy established the diagnosis of lymphangioma.

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A 52-year-old woman with a 7-month history of a left lateral upper eyelid nodule presented with an acute, 1-day history of left upper eyelid swelling and erythema associated with chemosis, epiphora, and pain. Magnetic resonance (MR) imaging revealed a well-circumscribed cystic mass indistinguishable from the left lacrimal gland containing a fluid-fluid level. Surgery confirmed an abscess within the lacrimal gland; histopathologic examination revealed a dilated lacrimal duct with an inflammatory exudate within the lumen.

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A 59-year-old woman presented with a 4-year history of a progressively growing, subcutaneous, painless, left lower eyelid mass with associated swelling and discomfort. Excisional biopsy established the diagnosis of a myoepithelioma, a tumor which, to the authors' knowledge, has not been previously reported in the lower eyelid.

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Intravascular papillary endothelial hyperplasia (IPEH) is a benign vascular lesion, typically found in the skin, consisting of a papillary proliferation of endothelial cells intimately related to a thrombus; it appears to be a rare variant of an organizing process. IPEH very rarely develops in the periocular region, with fewer than 20 such cases currently reported in the English language literature. We describe one of the largest ever case series of this uncommon lesion occurring in the periocular region and discuss its clinical features, imaging characteristics, and surgical management.

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