Current practice trends for lacrimal gland neurotoxin in the management of epiphora-a BOPSS survey.

Purpose: Injection of botulinum neurotoxin A (BoNTA) to the lacrimal gland (LG) offers a simple and effective treatment in the management of epiphora. However, there is little data on current practice trends or uptake as an alternative to surgery. This study assesses current practice trends of such treatment amongst BOPSS (British Oculoplastic Surgery Society) members.

Cutaneous pleomorphic adenoma of the periocular region - a case series.

Mixed tumour of the skin is a rare entity also known as chondroid syringoma and pleomorphic adenoma. These usually present as slow-growing skin nodules with a smooth surface, clear boundaries, and no ulceration. Case series exist describing pleomorphic adenomas in the periocular region including the lids and orbit, separate to the more familiar lacrimal gland pleomorphic adenoma.

Prostaglandin analogues: A double-edged sword in orbital glaucoma disease management.

Introduction: The authors describe benefits of the recognised adverse effects of prostaglandin analogues on periocular structures in patients with unilateral proptosis and intraocular pressure rise. This case points to intentional consideration of prostaglandin analogue therapy in this selected cohort of patients with secondary ocular hypertension and proptosis.

Case Description: A 70-year-old gentleman who presented with a 1-week history of a red and painful right eye associated with tortuous and dilated episcleral blood vessels.

Incidence of canalicular closure with endonasal dacryocystorhinostomy without intubation in primary nasolacrimal duct obstruction.

Purpose: To describe the incidence of canalicular closure with powered endonasal dacryocystorhinostomy (DCR) without canalicular intubation in primary acquired nasolacrimal duct obstruction (PANDO).

Design: A single-surgeon, prospective, nonrandomized, noncomparative, interventional case series.

Participants: Consecutive patients attending a specialist clinic of an oculoplastic surgeon (DS) with radiologically confirmed diagnosis of PANDO.

Endoscopic transcaruncular repair of large medial orbital wall fractures near the orbital apex.

Purpose: To study the suitability of an endoscopic transcaruncular approach (ETA) for repair of large medial orbital wall fractures (MOWFs) near the orbital apex.

Design: A retrospective, noncomparative case series with description of the surgical technique.

Participants: Ninety-three consecutive patients (93 orbits) with large isolated MOWFs near the orbital apex.

Management of upper eyelid cicatricial entropion.

Purpose: There is a paucity of published data on the management of upper eyelid cicatricial entropion. We report on our results using such techniques as lamella repositioning, recession or augmentation and terminal tarsal rotation.

Design: Observational retrospective case series.

Endoscopic transethmoidal and transconjunctival inferior fornix approaches for repairing the combined medial wall and orbital floor blowout fractures.

Purpose: To assess the combination of an endoscopic transethmoidal approach (ETEA) and a transconjunctival inferior fornix approach (TIFA) for repairing combined orbital floor and medial wall blowout fractures (COF-MWBOFs).

Methods: Patients with unilateral COF-MWBOFs were randomized to 2 groups: ETEA combined with TIFA or medial canthal incision (MCI) combined with TIFA. Thin porous polyethylene sheets were implanted to cover the orbital defects.

A multi-centre case series investigating the aetiology of hypertrophic pachymeningitis with orbital inflammation.

Introduction: To describe our attempt in establishing a definitive diagnosis in patients with hypertrophic pachymeningitis in combination with orbital inflammatory disease and report on the outcome.

Materials And Methods: This was a retrospective case series of all patients presenting with hypertrophic pachymeningitis in association with orbital inflammation in 4 centres. Ophthalmic and neurological examination data, laboratory data, histology data, treatment plans and clinical outcome data were recorded.

Composite grafts in eyelid reconstruction: the complications and outcomes.

Aims: To describe the outcomes and complications for composite eyelid grafts in a large case series over a 9-year period.

Method: A retrospective study of all patients who underwent a composite graft for eyelid reconstruction between January 2000 and May 2009. A composite eyelid graft involves the excision of a full thickness pentagonal wedge from the donor eyelid, which is inserted into the recipient eyelid defect.

The use of soft tissue expanders in periocular reconstruction: a case series.

Purpose: To describe the use of soft tissue expanders for periocular reconstruction in the presence of limited local tissue availability.

Methods: A retrospective case series of 5 patients who attended the Manchester Royal Eye Hospital. They presented a reconstructive challenge due either to the presence of periocular scarring or to a marked loss or limitation of normal local skin for reconstruction.

Recovery of Visual Function in a Patient with an Onodi Cell Mucocele Compressive Optic Neuropathy Who Had a 5-Week Interval between Onset and Surgical Intervention: A Case Report.

Purpose. To report on a patient with compressive optic neuropathy secondary to an Onodi cell mucocele, who fully recovered visual function following surgery. Method.

Lesions mimicking lacrimal gland pleomorphic adenoma.

Aim: To report a series of patients with lacrimal gland lesions simulating the clinicoradiological features of lacrimal gland pleomorphic adenoma (LGPA).

Methods: Multicentre retrospective, interventional case series. Clinical records of all patients with lesions mimicking LGPA seen in five orbital units were reviewed.

The ophthalmic side-effects of imiquimod therapy in the management of periocular skin lesions.

Aim: To describe the ophthalmic side-effects of topical imiquimod for periocular actinic keratoses, squamous cell carcinoma in situ and basal cell carcinoma.

Method: A retrospective study was carried out in two centres of all patients who underwent topical imiquimod therapy between January 2004 and January 2009. Imiquimod was applied three times weekly for 4-6 weeks.

Visual acuity recovery in traumatic optic neuropathy following endoscopic optic nerve decompression: a case report.

A 59-year-old Chinese man presented with no light perception in the left eye 1 day following functional endoscopic sinus surgery. The patient underwent endoscopic optic nerve decompression with topical and systemic application of nerve growth factor and steroids after a failed trial of high-dose intravenous corticosteroids. Visual acuity improved to 20/25 at 3 weeks and remained stable at 9 months.

Extramedullary plasmacytoma arising from the lacrimal gland.

An 80-year-old man presented with an 8-week history of painless swelling in the right lacrimal gland region with infero-medial dystopia of the globe. The lesion was excised and histology confirmed an orbital plasmacytoma. Multiple myeloma screening was negative and a solitary extramedullary plasmacytoma arising from the lacrimal gland was diagnosed.

Hypertrophic changes of the lower eyelid margin after hughes procedure for eyelid reconstruction: the management and outcomes.

Purpose: To describe the management of lower eyelid margin hypertrophy as a complication of the Hughes procedure for eyelid reconstruction.

Methods: A retrospective review of all patients with lower eyelid hypertrophy after Hughes procedure. Patient demographics, management, histologic findings, and outcomes were recorded.

Difference in response to botulinum toxin type A treatment between patients with benign essential blepharospasm and hemifacial spasm.

Background: Botulinum toxin (BTX) is the first-line treatment in managing benign essential blepharospasm (BEB) and hemifacial spasm (HFS). We wished to assess the difference in duration of effect and the number of BTX treatments required to treat patients with BEB and HFS.

Methods: A prospective study of patients attending the BTX clinic in Manchester Royal Eye Hospital over 6 months.

Tonopen versus Goldmann applanation tonometry for detecting restrictive thyroid eye disease.

Purpose: In thyroid eye disease (TED), intraocular pressure (IOP) measurements are taken in both the primary and upgaze positions to elicit restrictive muscle disease. The aim of this study was to assess whether the IOP when measured with the eyes in upgaze (the Goldmann applanation tonometer [GAT] head applanating the inferior/peripheral cornea) is similar when compared with the central corneal IOP in upgaze using the Tono-Pen XL.

Methods: IOP was measured with the GAT on the central cornea in primary gaze and on the inferior cornea in upgaze.

The surgical management and outcomes for spheno-orbital meningiomas: a 7-year review of multi-disciplinary practice.

Aims/purpose: Spheno-orbital meningiomas account for 9% of all adult intracranial meningiomas. Complete resection is extremely difficult with this condition. We report on our experience in the surgical management of spheno-orbital meningiomas.

Air regurgitation in patients on continuous positive airway pressure (CPAP) therapy following dacrocystorhinostomy with or without Lester-Jones tube insertion.

Aim: To describe air regurgitation as a complication in patients on continuous positive airway pressure (CPAP) therapy for obstructive sleep apnoea (OSA) following dacryocystorhinostomy (DCR) surgery with or without Lester-Jones tube (LJT) insertion.

Methods: A retrospective review of all patients with air regurgitation on CPAP therapy who previously underwent a DCR/LJT procedure. Patient demographics, lacrimal surgical history, CPAP therapy and outcome were recorded.

Can eyelid taping predict the benefit of a lateral tarsal strip procedure in patients with eyelid laxity and functional epiphora?

Purpose: To determine whether taping of the lower eyelid laterally and upward onto the temple region (to mimic a lateral tarsal strip procedure) can effectively predict whether lateral tarsal strip surgery will lead to resolution or improvement in functional epiphora by correcting eyelid laxity.

Methods: A case series of 28 eyes in 20 patients with symptomatic epiphora and equivocal lateral eyelid laxity were identified. The inclusion criteria included patent nasolacrimal systems on syringing with no other eyelid malposition or obvious cause for epiphora.