Anatomical etiology of bunny lines based on cadaveric dissection and ultrasonographic evaluation.

Bunny lines are vertical and diagonal wrinkles attributed to contractions of the nasalis muscle. Common management involves botulinum toxin (BoNT) injections into wrinkles immediately below the nasal bridge. Here, we investigated the anatomical structures underneath bunny lines and their relationships with adjacent muscular structures.

Etiology of Delayed Inflammatory Reaction Induced by Hyaluronic Acid Filler.

The etiology and pathophysiology of delayed inflammatory reactions caused by hyaluronic acid fillers have not yet been elucidated. Previous studies have suggested that the etiology can be attributed to the hyaluronic acid filler itself, patient's immunological status, infection, and injection technique. Hyaluronic acid fillers are composed of high-molecular weight hyaluronic acids that are chemically cross-linked using substances such as 1,4-butanediol diglycidyl ether (BDDE).

Cosmetic Filler-Induced Vascular Occlusion: A Rising Threat Presenting to Emergency Departments.

Vascular emergencies from cosmetic filler-induced vascular occlusion represent an iatrogenic etiology that poses a threat to patients, with sequelae that range from disfiguring skin necrosis to blindness and stroke. As cosmetic fillers continue to grow in popularity, the importance of early identification, triaging, and management of these rare but potentially disabling injuries has motivated efforts to educate the public and professional audiences. In this practice review article, we outline components of acute care pertaining to these injuries based on evolving practice guidelines and best evidence recommendations.

Novel technique of non-surgical rejuvenation of infraorbital dark circles.

Background: Infraorbital dark circles are a common esthetic concern which can be challenging to treat given their multifactorial nature. Under-eye dark circles are seen in all skin types, with a strong familial component in darker skin types. Other major contributing factors include soft tissue and bony changes, skin changes, lifestyle contributions, and allergies.

Awareness of management of hyaluronic acid induced visual loss: A British National Survey.

Background: Visual loss from aesthetic hyaluronic acid filler injections is an under-reported complication. Our study surveyed British Oculoplastic consultants and Consultant members of the British Eye Emergency Care Society, on their awareness of visual vascular complications of dermal fillers and its emergency management.

Methods: A prospective survey of the members of the British Oculoplastic Society and the British Eye Emergency Society, using the Survey Monkey platform.

Nylon Hang Back Sutures in the Repair of Secondary Ptosis Following Overcorrected Dysthyroid Upper Eyelid Retraction.

Purpose: Repair of blepharoptosis secondary to surgical overcorrection of thyroid related primary upper eyelid retraction (secondary ptosis) can be unpredictable. This study describes the long-term results of "hang-back" nylon sutures, for an anterior approach surgical repair of secondary ptosis.

Methods: This was a retrospective consecutive case note review of patients referred with secondary ptosis (after prior upper eyelid lowering for thyroid eye disease), under the care of a single surgeon at Moorfields Eye Hospital & subsequently at Barking Havering Redbridge University Hospitals NHS Trust (SSD).

A Skin Crease Preserving Modification of Open-Sky Mullerectomy for Blepharoptosis Correction.

Purpose: To report the results of skin crease preservation with a modified technique of open-sky Muller's muscle-conjunctival resection that precludes the need to reconstruct the upper eyelid skin crease with full thickness sutures.

Methods: A nonrandomized, retrospective audit of 45 eyelids of 37 consecutive patients with acquired blepharoptosis, undergoing surgical correction by a single surgeon, between November 2011 and July 2014. Surgical technique involved subtotal resection of Muller's muscle plus underlying conjunctiva, under direct visualization.

Sliding tarsal advancement flap for upper eyelid reconstruction.

The Sliding Tarsal Advancement Flap, a modification of Hughes procedure has been used for the repair of large upper eyelid defects in three patients. The procedure yielded both good functional and aesthetic outcomes. At presentation the defect measured 50% in two cases and >50% in one case.

Two new cases of metastatic basal cell carcinoma from the eyelids.

Background: Basal cell carcinoma (BCC) is an extremely common malignancy. Unlike other skin cancers, it very rarely metastasises.

Methods: We present two cases of advanced BCC on the eyelids that metastasized to the parotid region after local excision.

Stability of eyelid height after graded anterior-approach lid lowering for dysthyroid upper lid retraction.

Objective: To investigate the outcome of a modified anterior approach surgical procedure for the correction of primary upper eyelid retraction in thyroid eye disease.

Methods: A retrospective review of 52 consecutive cases (in 32 patients) of anterior-approach graded upper lid lowering for the treatment of primary eyelid retraction, carried out at Moorfields Eye Hospital between 2006-2009 was conducted. Measurements of upper margin-reflex distance (MRD), upper lid skin crease height and skin fold height were taken from clinical records and photographs.

Scleral contact lens usage in patients with complex blepharoptosis.

Purpose: To evaluate the efficacy of scleral contact lenses (ScCLs) as an alternative or as an adjunct to surgical correction for the management of complex ptosis.

Methods: A retrospective case-note review was used to determine the subjective function and cosmetic acceptability of the lenses. Digital photographs were taken, both with and without the lens in place; analytic software was used to assess the vertical height of the palpebral aperture (PA) and the upper margin-reflex distance.

Digital image analysis to characterize the upper lid marginal peak after levator aponeurosis repair.

Purpose: Lid contour is important for eyelid symmetry, but clinical quantification can be difficult. The marginal peak is a major determinant of upper eyelid contour, and its horizontal position, relative to the mid-pupillary line, may be used as a measure of symmetry after surgery. This study used digital image analysis to assess the peak position in patients who had undergone levator aponeurosis repair.

Long-term outcomes of surgical approaches to the treatment of floppy eyelid syndrome.

Objective: To identify and describe the different procedures used in the treatment of floppy eyelid syndrome (FES) at Moorfields Eye Hospital and to evaluate their effectiveness.

Design: Cross-sectional study.

Participants: A total of 71 patients who had undergone surgery for FES over a 13-year period since 1995 at Moorfields Eye Hospital were recruited.

Lax eyelid syndrome or 'progeria' of eyelid tissues.

Purpose: The lax eyelid syndrome was described by Van den Bosch and Lemij as an uncommon disorder seen in non-obese elderly people and characterised by chronic ocular surface irritation symptoms and a "floppy upper eyelid". The authors present some new features of the lax eyelid syndrome.

Methods: The authors report five patients, belonging to a younger age group, who presented with premature laxity of all the eyelid tissues.

Surgical correction of entropion and excess upper eyelid skin in congenital cutis laxa: a case report.

Congenital cutis laxa is a rare generalized inherited elastosis, characterized by the appearance of premature aging and skin laxity with mild to severe systemic anomalies. Ocular manifestations include excess skin in the eyelids, ptosis and lower lid ectropion. Of the hyperelasticity syndromes - Ehlers Danlos, Pseudoxanthoma elasticum and cutis laxa - only cutis laxa has normal skin wound healing.

Role of the lower lid retractors in involutional ectropion repair.

AIM. To outline the role of the lower lid retractors in correction of involutional ectropion. METHODS.