Pub Date : 2019-11-27DOI: 10.1097/IOP.0000000000001554
Lauren R Schaffer, H. Kim, H. Grossniklaus
Basal cell carcinoma accounts for 90% of malignant tumors of the eyelid. Basal cell carcinoma has been reported to rarely occur in conjunction with osteoma cutis or bone formation in the skin. The mechanism of this secondary osteoma cutis has yet to be explained. Herein, the authors present the case of a 68-year-old woman with a rapidly enlarging basal cell carcinoma with secondary osteoma cutis of the left lower eyelid.
{"title":"Basal Cell Carcinoma of the Eyelid With Metaplastic Bone Formation.","authors":"Lauren R Schaffer, H. Kim, H. Grossniklaus","doi":"10.1097/IOP.0000000000001554","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001554","url":null,"abstract":"Basal cell carcinoma accounts for 90% of malignant tumors of the eyelid. Basal cell carcinoma has been reported to rarely occur in conjunction with osteoma cutis or bone formation in the skin. The mechanism of this secondary osteoma cutis has yet to be explained. Herein, the authors present the case of a 68-year-old woman with a rapidly enlarging basal cell carcinoma with secondary osteoma cutis of the left lower eyelid.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75290618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-27DOI: 10.1097/IOP.0000000000001540
Sarah Chan, Christopher M. Stewart
A 37-year-old male was found to have a firm yellowy-white palpable mass embedded within the conjunctival surface of the tarsal plate of the left upper eyelid. This was asymptomatic and noted on a routine examination for contralateral epiphora. An excisional biopsy was performed and a "rock-like nodule" was removed with histopathology confirming the presence of mature bone. While the literature describes these lesions located in other aspects of the orbit, this is the first described case of an epibulbar osseous choristoma located in the tarsal plate of the upper eyelid.
{"title":"Epibulbar Osseous Choristoma: A Rare Find in the Superior Conjunctival Tarsal Plate of the Upper Eyelid.","authors":"Sarah Chan, Christopher M. Stewart","doi":"10.1097/IOP.0000000000001540","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001540","url":null,"abstract":"A 37-year-old male was found to have a firm yellowy-white palpable mass embedded within the conjunctival surface of the tarsal plate of the left upper eyelid. This was asymptomatic and noted on a routine examination for contralateral epiphora. An excisional biopsy was performed and a \"rock-like nodule\" was removed with histopathology confirming the presence of mature bone. While the literature describes these lesions located in other aspects of the orbit, this is the first described case of an epibulbar osseous choristoma located in the tarsal plate of the upper eyelid.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89397310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-27DOI: 10.1097/IOP.0000000000001481
Meleha T. Ahmad, Nickisa M. Hodgson, M. Repka, Ashley A. Campbell
e106 Ophthalmic Plast Reconstr Surg, Vol. 36, No. 4, 2020 An otherwise healthy 82-year-old male presented with painless binocular diplopia for 6 weeks and worsening vision in the left eye for 3 days. Visual acuity was 20/20 OD and count fingers at 3 feet OS with a left relative afferent pupillary defect. He had a left hypertropia (Fig. A) and significant limitation in supraduction OD, and supraduction, adduction and abduction OS. Orbital CT demonstrated nonuniform enlargement of the right superior rectus muscle anteriorly (Fig. B1) and the left lateral rectus muscle posteriorly (Fig. B2) with tendon sparing and significant mass effect on the left optic nerve at the apex. Biopsy of the left lateral rectus muscle was consistent with marginal zone B-cell lymphoma (Fig. C). The optic neuropathy resolved completely following intravenous steroids and R-mini CHOP chemotherapy (Rituxamab and reduced dose cyclophosphamide, doxorubicin, vincristine, and prednisone). His motility defects resolved other than a persistent −2 deficit in abduction OS. Workup for metastasis was negative. Orbital lymphoma is the most common primary orbital malignancy, with marginal zone B-cell lymphoma being the most common histologic subtype. Extraocular muscle is the least common site of involvement and bilateral involvement is extremely rare.
{"title":"Bilateral Extraocular Muscle B-Cell Lymphoma in an Elderly Male.","authors":"Meleha T. Ahmad, Nickisa M. Hodgson, M. Repka, Ashley A. Campbell","doi":"10.1097/IOP.0000000000001481","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001481","url":null,"abstract":"e106 Ophthalmic Plast Reconstr Surg, Vol. 36, No. 4, 2020 An otherwise healthy 82-year-old male presented with painless binocular diplopia for 6 weeks and worsening vision in the left eye for 3 days. Visual acuity was 20/20 OD and count fingers at 3 feet OS with a left relative afferent pupillary defect. He had a left hypertropia (Fig. A) and significant limitation in supraduction OD, and supraduction, adduction and abduction OS. Orbital CT demonstrated nonuniform enlargement of the right superior rectus muscle anteriorly (Fig. B1) and the left lateral rectus muscle posteriorly (Fig. B2) with tendon sparing and significant mass effect on the left optic nerve at the apex. Biopsy of the left lateral rectus muscle was consistent with marginal zone B-cell lymphoma (Fig. C). The optic neuropathy resolved completely following intravenous steroids and R-mini CHOP chemotherapy (Rituxamab and reduced dose cyclophosphamide, doxorubicin, vincristine, and prednisone). His motility defects resolved other than a persistent −2 deficit in abduction OS. Workup for metastasis was negative. Orbital lymphoma is the most common primary orbital malignancy, with marginal zone B-cell lymphoma being the most common histologic subtype. Extraocular muscle is the least common site of involvement and bilateral involvement is extremely rare.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"162 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73127198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-21DOI: 10.1097/IOP.0000000000001505
Bryce R Radmall, Aron D. Sampson, N. Syed, A. C. Ko
Ophthalmic Plast Reconstr Surg, Vol. 36, No. 5, 2020 e135 A 60-year-old woman with no significant medical history presented to an outside eye care provider for a persistent right lower eyelid lesion. This lesion was diagnosed as a chalazion, and she underwent incision and drainage. Postoperatively, the lesion did not resolve and maintained the same size and appearance. She was referred 6 months later for tarsal cyst excision. Examination was remarkable for an intratarsal cystic lesion involving the margin of the right lower eyelid (Fig. A, B). There was no associated madarosis, ulceration, bleeding, keratinization, or telangiectasia. A wedge excision and reconstruction were performed. Pathologic examination revealed a poorly differentiated sebaceous carcinoma (Fig. C, D). The patient underwent a second resection and conjunctival map biopsies, which showed negative surgical margins and no conjunctival involvement. She subsequently underwent reconstruction, and there was no evidence of recurrence at 6-month follow-up. Sebaceous carcinoma is a relatively rare, aggressive malignancy most commonly arising from the periocular tissues including the meibomian glands of the tarsus, and the glands of Zeis of the eyelashes, caruncle, and skin of the eyebrow. Although sebaceous carcinoma accounts for only 0.5% of all eyelid lesions, it is the most concerning because it is associated with increased morbidity and mortality. This periocular malignancy is notoriously difficult to diagnose, masquerading as an assortment of conditions which frequently leads to delays in diagnosis and proper treatment in greater than two thirds of cases. Despite a seemingly benign appearance, any lesion with yellow coloration and thickening of the eyelid or adjacent conjunctiva should cause the clinician to consider sebaceous carcinoma as a possibility with a low threshold for biopsy.
{"title":"Periocular Sebaceous Carcinoma Masquerading as an Intratarsal Cyst.","authors":"Bryce R Radmall, Aron D. Sampson, N. Syed, A. C. Ko","doi":"10.1097/IOP.0000000000001505","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001505","url":null,"abstract":"Ophthalmic Plast Reconstr Surg, Vol. 36, No. 5, 2020 e135 A 60-year-old woman with no significant medical history presented to an outside eye care provider for a persistent right lower eyelid lesion. This lesion was diagnosed as a chalazion, and she underwent incision and drainage. Postoperatively, the lesion did not resolve and maintained the same size and appearance. She was referred 6 months later for tarsal cyst excision. Examination was remarkable for an intratarsal cystic lesion involving the margin of the right lower eyelid (Fig. A, B). There was no associated madarosis, ulceration, bleeding, keratinization, or telangiectasia. A wedge excision and reconstruction were performed. Pathologic examination revealed a poorly differentiated sebaceous carcinoma (Fig. C, D). The patient underwent a second resection and conjunctival map biopsies, which showed negative surgical margins and no conjunctival involvement. She subsequently underwent reconstruction, and there was no evidence of recurrence at 6-month follow-up. Sebaceous carcinoma is a relatively rare, aggressive malignancy most commonly arising from the periocular tissues including the meibomian glands of the tarsus, and the glands of Zeis of the eyelashes, caruncle, and skin of the eyebrow. Although sebaceous carcinoma accounts for only 0.5% of all eyelid lesions, it is the most concerning because it is associated with increased morbidity and mortality. This periocular malignancy is notoriously difficult to diagnose, masquerading as an assortment of conditions which frequently leads to delays in diagnosis and proper treatment in greater than two thirds of cases. Despite a seemingly benign appearance, any lesion with yellow coloration and thickening of the eyelid or adjacent conjunctiva should cause the clinician to consider sebaceous carcinoma as a possibility with a low threshold for biopsy.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84344470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-21DOI: 10.1097/IOP.0000000000001517
A. Basilious, Imran Jivraj, D. Deangelis
The authors present a rare case of sudden onset unilateral complete ptosis occurring hours after administration of the H1N1 influenza vaccine. A complete workup for autoimmune and neurological disease was negative. MRI of the orbits demonstrated unilateral orbital myositis involving the left superior rectus/levator complex, superior oblique, and medial rectus muscles. Ptosis resolved spontaneously over 2 months without intervention. An autoimmune mechanism may explain rare cases of orbital myositis following administration of the H1N1 influenza vaccination.
{"title":"Acute Unilateral Ptosis and Myositis Following the H1N1 Influenza Vaccine.","authors":"A. Basilious, Imran Jivraj, D. Deangelis","doi":"10.1097/IOP.0000000000001517","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001517","url":null,"abstract":"The authors present a rare case of sudden onset unilateral complete ptosis occurring hours after administration of the H1N1 influenza vaccine. A complete workup for autoimmune and neurological disease was negative. MRI of the orbits demonstrated unilateral orbital myositis involving the left superior rectus/levator complex, superior oblique, and medial rectus muscles. Ptosis resolved spontaneously over 2 months without intervention. An autoimmune mechanism may explain rare cases of orbital myositis following administration of the H1N1 influenza vaccination.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82461391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-21DOI: 10.1097/IOP.0000000000001440
Rocio Bentivegna, G. Espinoza
e82 Ophthalmic Plast Reconstr Surg, Vol. 36, No. 3, 2020 A 68-year-old woman presented with a 1-year history of diplopia, discomfort, and pressure around her left orbit and forehead. She noted gradual painless left eye proptosis during the last 4 years. On examination, there was a 4-mm downward displacement of the left globe with 6 mm of relative proptosis (Fig. A). Her ocular exam was normal other than exotropia and limited upgaze. Magnetic resonance imaging (Fig. B,C) showed an expansive mass in the left frontal skull extending into the orbit, displacing the globe and the frontal lobe. Computed tomography revealed a well-circumscribed lesion with a honeycombed appearance (Fig. D). Fine needle aspiration was performed at time of presentation through a palpable orbital rim bony defect to facilitate timely diagnosis and treatment. The aspiration confirmed the vascular nature of the lesion, and cytology report was negative for malignancy. During subsequent stereotactic craniotomy surgery, the authors encountered a vascular intraosseous lesion with adherence to dura mater and brittle bone at the orbital rim (Fig. E). Loss of the orbital roof and superior orbital rim due to lesion invasion was also observed. Tissue sample confirmed the diagnosis of intraosseous cavernous hemangioma. Intraosseous cavernous hemangiomas involving the orbital bones with intracranial extension are exceedingly uncommon with only five previously reported cases. These lesions originate from the vessels in the diploic space and typically erode the outer table of the calvarium with rare involvement of the inner table. Surgical excision is the most common therapeutic treatment of this benign lesion.
{"title":"Orbital and Cranial Extension of an Intraosseous Cavernous Hemangioma.","authors":"Rocio Bentivegna, G. Espinoza","doi":"10.1097/IOP.0000000000001440","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001440","url":null,"abstract":"e82 Ophthalmic Plast Reconstr Surg, Vol. 36, No. 3, 2020 A 68-year-old woman presented with a 1-year history of diplopia, discomfort, and pressure around her left orbit and forehead. She noted gradual painless left eye proptosis during the last 4 years. On examination, there was a 4-mm downward displacement of the left globe with 6 mm of relative proptosis (Fig. A). Her ocular exam was normal other than exotropia and limited upgaze. Magnetic resonance imaging (Fig. B,C) showed an expansive mass in the left frontal skull extending into the orbit, displacing the globe and the frontal lobe. Computed tomography revealed a well-circumscribed lesion with a honeycombed appearance (Fig. D). Fine needle aspiration was performed at time of presentation through a palpable orbital rim bony defect to facilitate timely diagnosis and treatment. The aspiration confirmed the vascular nature of the lesion, and cytology report was negative for malignancy. During subsequent stereotactic craniotomy surgery, the authors encountered a vascular intraosseous lesion with adherence to dura mater and brittle bone at the orbital rim (Fig. E). Loss of the orbital roof and superior orbital rim due to lesion invasion was also observed. Tissue sample confirmed the diagnosis of intraosseous cavernous hemangioma. Intraosseous cavernous hemangiomas involving the orbital bones with intracranial extension are exceedingly uncommon with only five previously reported cases. These lesions originate from the vessels in the diploic space and typically erode the outer table of the calvarium with rare involvement of the inner table. Surgical excision is the most common therapeutic treatment of this benign lesion.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"163 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86676524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-18DOI: 10.1097/IOP.0000000000001458
Z. Gur, Catherine Y. Liu, Bobby S. Korn, D. Kikkawa
Ophthalmic Plast Reconstr Surg, Vol. 36, No. 3, 2020 e83 Mycobacterium fortuitum is a rare opportunistic infection. A 84-year-old woman presented with a 4-week history of purulent discharge from the right eye. Her past medical history includes diabetes mellitus and rheumatoid arthritis treated with abatacept (Orencia). On examination, she had right phthisis bulbi with an exposed and infected scleral buckle (Fig. A, arrow). Enucleation with removal of the exposed scleral buckle band was performed. Cultures revealed M. fortuitum. No implant was placed at the time of the enucleation. Postoperatively, the patient worsened despite therapy with bacteria-sensitive oral Ciprofloxacin. Clinically, the discharge improved but the pain and swelling persisted. CT imaging was obtained postoperatively and revealed that the entire right orbit was f illed with an enhancing amorphous material consistent with extensive atypical mycobacterial soft tissue infection (Fig. B). Infectious disease consultation recommended an extended course of trimethoprim/ sulfamethoxazole, cefoxitin, and amikacin. The patient recovered without complications. This report illustrates a rare case of extensive atypical mycobacterial infection of the orbit caused by exposed scleral buckle.
{"title":"Exposed Scleral Buckle Causing Atypical Mycobacterial Infection.","authors":"Z. Gur, Catherine Y. Liu, Bobby S. Korn, D. Kikkawa","doi":"10.1097/IOP.0000000000001458","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001458","url":null,"abstract":"Ophthalmic Plast Reconstr Surg, Vol. 36, No. 3, 2020 e83 Mycobacterium fortuitum is a rare opportunistic infection. A 84-year-old woman presented with a 4-week history of purulent discharge from the right eye. Her past medical history includes diabetes mellitus and rheumatoid arthritis treated with abatacept (Orencia). On examination, she had right phthisis bulbi with an exposed and infected scleral buckle (Fig. A, arrow). Enucleation with removal of the exposed scleral buckle band was performed. Cultures revealed M. fortuitum. No implant was placed at the time of the enucleation. Postoperatively, the patient worsened despite therapy with bacteria-sensitive oral Ciprofloxacin. Clinically, the discharge improved but the pain and swelling persisted. CT imaging was obtained postoperatively and revealed that the entire right orbit was f illed with an enhancing amorphous material consistent with extensive atypical mycobacterial soft tissue infection (Fig. B). Infectious disease consultation recommended an extended course of trimethoprim/ sulfamethoxazole, cefoxitin, and amikacin. The patient recovered without complications. This report illustrates a rare case of extensive atypical mycobacterial infection of the orbit caused by exposed scleral buckle.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"185 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81062451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-18DOI: 10.1097/IOP.0000000000001534
Emily Li, J. Sinard, M. Sohrab
A 56-year-old man presented with a periorbital subcutaneous mass and ipsilateral visually significant orbital inflammation that was refractory to broad-spectrum antibiotics. Orbitotomy with biopsy revealed the diagnosis of metastatic lung cancer, and the patient was initiated on systemic chemotherapy and adjuvant radiation. This is the first report of pulmonary adenocarcinoma metastatic simultaneously to the periocular cutaneous and intraorbital soft tissues. Atypical periorbital and orbital inflammation may be the initial presentation of occult malignancy and require a high index of suspicion and tissue biopsy for diagnosis and life-saving management.
{"title":"Pulmonary Adenocarcinoma Metastatic to Periocular Skin and Orbital Tissue Presenting as Orbital Cellulitis.","authors":"Emily Li, J. Sinard, M. Sohrab","doi":"10.1097/IOP.0000000000001534","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001534","url":null,"abstract":"A 56-year-old man presented with a periorbital subcutaneous mass and ipsilateral visually significant orbital inflammation that was refractory to broad-spectrum antibiotics. Orbitotomy with biopsy revealed the diagnosis of metastatic lung cancer, and the patient was initiated on systemic chemotherapy and adjuvant radiation. This is the first report of pulmonary adenocarcinoma metastatic simultaneously to the periocular cutaneous and intraorbital soft tissues. Atypical periorbital and orbital inflammation may be the initial presentation of occult malignancy and require a high index of suspicion and tissue biopsy for diagnosis and life-saving management.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91080969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-14DOI: 10.1097/IOP.0000000000001509
Marissa K. Shoji, Ann Q. Tran, Neda Nikpoor, Wendy W. Lee
A 64-year-old woman underwent bilateral upper eyelid blepharoplasty and subsequently presented with decreased vision at her first postoperative visit 1 week later. She was found to have an 8-mm partial-thickness corneal laceration of her left eye and underwent immediate surgical laceration repair. The laceration etiology was thought to be related to damage from the initial blepharoplasty incision or Bovie cautery tip-induced laceration. After laceration repair, she had residual astigmatism and corneal scarring leading to poor vision. Corneal injuries, including abrasions and perforations, are rare complications of blepharoplasty, and the case in this study is the first report of corneal laceration following blepharoplasty. Corneal perforations and lacerations can lead to significant damage and vision loss, indicating a need for careful attention to surgical technique and instrument placement intraoperatively, routine use of corneal protectors even during superficial aesthetic procedures such as blepharoplasties, and comprehensive postoperative patient instructions.
{"title":"Corneal Laceration Associated With Upper Eyelid Blepharoplasty.","authors":"Marissa K. Shoji, Ann Q. Tran, Neda Nikpoor, Wendy W. Lee","doi":"10.1097/IOP.0000000000001509","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001509","url":null,"abstract":"A 64-year-old woman underwent bilateral upper eyelid blepharoplasty and subsequently presented with decreased vision at her first postoperative visit 1 week later. She was found to have an 8-mm partial-thickness corneal laceration of her left eye and underwent immediate surgical laceration repair. The laceration etiology was thought to be related to damage from the initial blepharoplasty incision or Bovie cautery tip-induced laceration. After laceration repair, she had residual astigmatism and corneal scarring leading to poor vision. Corneal injuries, including abrasions and perforations, are rare complications of blepharoplasty, and the case in this study is the first report of corneal laceration following blepharoplasty. Corneal perforations and lacerations can lead to significant damage and vision loss, indicating a need for careful attention to surgical technique and instrument placement intraoperatively, routine use of corneal protectors even during superficial aesthetic procedures such as blepharoplasties, and comprehensive postoperative patient instructions.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"125 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78455127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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