Pub Date : 2019-11-01DOI: 10.1097/IOP.0000000000001478
Ritah Chumdermpadetsuk, Andrea A. Tooley, Kyle J. Godfrey, Brian D. Krawitz, N. Feldstein, M. Kazim
A 22-year-old Hispanic man with sickle cell trait presented with blurred vision, double vision, and pain with OD movement. MRI demonstrated an extra-axial mass centered around the temporal bone with extension into the middle cranial fossa and lateral aspect of the extra-conal right orbit, and mass effect on the lateral rectus muscle. Biopsy of the lesion was consistent with renal medullary carcinoma. CT chest/abdomen/pelvis confirmed a primary tumor in the right kidney. No additional metastases were found. Renal medullary carcinoma is a rare, highly aggressive malignancy, which almost exclusively affects young men of African descent with sickle cell trait or sickle cell disease. The authors present the second confirmed case of renal medullary carcinoma metastatic to the orbit, with ocular symptoms prior the typical presenting symptoms of flank pain and hematuria.
{"title":"Renal Medullary Carcinoma With Metastasis to the Temporal Fossa and Orbit.","authors":"Ritah Chumdermpadetsuk, Andrea A. Tooley, Kyle J. Godfrey, Brian D. Krawitz, N. Feldstein, M. Kazim","doi":"10.1097/IOP.0000000000001478","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001478","url":null,"abstract":"A 22-year-old Hispanic man with sickle cell trait presented with blurred vision, double vision, and pain with OD movement. MRI demonstrated an extra-axial mass centered around the temporal bone with extension into the middle cranial fossa and lateral aspect of the extra-conal right orbit, and mass effect on the lateral rectus muscle. Biopsy of the lesion was consistent with renal medullary carcinoma. CT chest/abdomen/pelvis confirmed a primary tumor in the right kidney. No additional metastases were found. Renal medullary carcinoma is a rare, highly aggressive malignancy, which almost exclusively affects young men of African descent with sickle cell trait or sickle cell disease. The authors present the second confirmed case of renal medullary carcinoma metastatic to the orbit, with ocular symptoms prior the typical presenting symptoms of flank pain and hematuria.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80323585","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 : 2019-11-01DOI: 10.1097/IOP.0000000000001463
Abdullah Ali, Hend E Alsafran, Hamad A Alomairah, Abdulaziz A Almazdi, R. Behbehani
Orbital subperiosteal hemorrhages are usually due to trauma. However, nontraumatic subperiosteal hemorrhages have also been rarely reported. Here, the authors present a 13-year-old boy with Bernard-Soulier syndrome who presented with right orbital subperiosteal hemorrhage causing optic neuropathy which was surgically drained with full visual recovery.
{"title":"Nontraumatic Orbital Subperiosteal Hematoma in a Case of Bernard-Soulier Syndrome With Bilateral Pansinusitis.","authors":"Abdullah Ali, Hend E Alsafran, Hamad A Alomairah, Abdulaziz A Almazdi, R. Behbehani","doi":"10.1097/IOP.0000000000001463","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001463","url":null,"abstract":"Orbital subperiosteal hemorrhages are usually due to trauma. However, nontraumatic subperiosteal hemorrhages have also been rarely reported. Here, the authors present a 13-year-old boy with Bernard-Soulier syndrome who presented with right orbital subperiosteal hemorrhage causing optic neuropathy which was surgically drained with full visual recovery.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75725980","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 : 2019-09-01DOI: 10.1097/IOP.0000000000001443
Yasmin S. Bradfield, C. Burkat, D. Albert, Heather A D Potter
A 7-year-old healthy girl presented for an evaluation of a left vascular scleral mass. The lesion appeared spontaneously with no history of trauma, coagulopathy, or topical medication use. It was nontender, enlarging, and did not extend intraocularly. Her OS vision was 20/20, and the remainder of her eye examination was normal. Evaluation of the ocular mass included B-scan ultrasound, ultrasound biomicroscopy, anterior segment optical coherence tomography (OCT), and orbital MRI. The anterior segment OCT demonstrated vessels within the mass with no defined capsule. The orbital MRI confirmed a lesion isolated to the scleral layers of the globe, with low blood flow. The patient had a partial response to oral propranolol. Because the lesion vessels began to extend into her corneal endothelium, there was a concern for malignancy. A biopsy confirmed a benign intrascleral capillary hemangioma. Discontinuation of the propranolol demonstrated stability of the lesion 6 months later.
{"title":"Capillary Hemangioma Presenting as a Scleral Vascular Lesion in a Child.","authors":"Yasmin S. Bradfield, C. Burkat, D. Albert, Heather A D Potter","doi":"10.1097/IOP.0000000000001443","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001443","url":null,"abstract":"A 7-year-old healthy girl presented for an evaluation of a left vascular scleral mass. The lesion appeared spontaneously with no history of trauma, coagulopathy, or topical medication use. It was nontender, enlarging, and did not extend intraocularly. Her OS vision was 20/20, and the remainder of her eye examination was normal. Evaluation of the ocular mass included B-scan ultrasound, ultrasound biomicroscopy, anterior segment optical coherence tomography (OCT), and orbital MRI. The anterior segment OCT demonstrated vessels within the mass with no defined capsule. The orbital MRI confirmed a lesion isolated to the scleral layers of the globe, with low blood flow. The patient had a partial response to oral propranolol. Because the lesion vessels began to extend into her corneal endothelium, there was a concern for malignancy. A biopsy confirmed a benign intrascleral capillary hemangioma. Discontinuation of the propranolol demonstrated stability of the lesion 6 months later.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88719302","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 : 2019-09-01DOI: 10.1097/IOP.0000000000001453
Caroline W. Wilson, M. T. Fisher, Nitin A. Pagedar, Gretchen Kass, W. Terry, E. Shriver
The aim of exenteration reconstruction is to stabilize the postsurgical wound bed to promote expeditious healing particularly in patients who are undergoing adjuvant radiation and/or chemotherapy. Porcine urinary bladder matrix has previously been used successfully as a wound-healing scaffold in treatment of burns and in acute, chronic, and surgical wounds, but the use of these products has not previously been reported in the exenterated orbit. The authors present a case of the novel use of porcine urinary bladder matrix in a pediatric patient who underwent exenteration for recurrent embryonal rhabdomyosarcoma, subsequent split-thickness skin grafting, and adjuvant radiation.
{"title":"Novel Use of Porcine Urinary Bladder Matrix in the Exenterated Socket.","authors":"Caroline W. Wilson, M. T. Fisher, Nitin A. Pagedar, Gretchen Kass, W. Terry, E. Shriver","doi":"10.1097/IOP.0000000000001453","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001453","url":null,"abstract":"The aim of exenteration reconstruction is to stabilize the postsurgical wound bed to promote expeditious healing particularly in patients who are undergoing adjuvant radiation and/or chemotherapy. Porcine urinary bladder matrix has previously been used successfully as a wound-healing scaffold in treatment of burns and in acute, chronic, and surgical wounds, but the use of these products has not previously been reported in the exenterated orbit. The authors present a case of the novel use of porcine urinary bladder matrix in a pediatric patient who underwent exenteration for recurrent embryonal rhabdomyosarcoma, subsequent split-thickness skin grafting, and adjuvant radiation.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73811931","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 : 2019-09-01DOI: 10.1097/IOP.0000000000001433
S. Kase, S. Ishida
Adenosquamous carcinoma is a highly aggressive tumor, which can rarely arise from the ocular surface. The authors herein report a patient who presented with a 5 mm mass on the temporal conjunctiva that was clinically diagnosed as squamous cell carcinoma. The lesion was surgically resected with cryopexy to the conjunctival wound edges. Histopathology and immunoractivity confirmed the diagnosis of adenosquamous carcinoma. Following topical interferon alpha 2b for 3 months, there has been no recurrence or distant metastsis during a follow-up of 12 months.
{"title":"Adenosquamous Carcinoma Arising in Bulbar Conjunctiva.","authors":"S. Kase, S. Ishida","doi":"10.1097/IOP.0000000000001433","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001433","url":null,"abstract":"Adenosquamous carcinoma is a highly aggressive tumor, which can rarely arise from the ocular surface. The authors herein report a patient who presented with a 5 mm mass on the temporal conjunctiva that was clinically diagnosed as squamous cell carcinoma. The lesion was surgically resected with cryopexy to the conjunctival wound edges. Histopathology and immunoractivity confirmed the diagnosis of adenosquamous carcinoma. Following topical interferon alpha 2b for 3 months, there has been no recurrence or distant metastsis during a follow-up of 12 months.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"AES-11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84520776","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 : 2019-05-01DOI: 10.1097/IOP.0000000000001389
A. Putterman
To the Editor: I read with great interest the article of Zatezalo et al. in a recent issue of the journal. The authors performed a randomized trial on 33 patients undergoing conjunctival Müller’s muscle resection and concluded that there was no statistically significant difference in pain scores or surgical outcomes in patients receiving frontal nerve block compared with those receiving subconjunctival injection. The authors should be congratulated for performing a well-designed study in an important topic (e.g., acute pain) in patients undergoing surgical procedures. The current emphasis on the need to reduce the use of opioids makes the topic very relevant in perioperative medicine. Although the study of Zatezalo et al. was well conducted, there are several questions regarding the study that need to be clarified to further confirm the validity of the results. First, it is unclear if the authors standardized the intraoperative and postoperative analgesic regimens as this can significantly affect the study results. Second, the authors did not detect a difference on pain scores, but it does not mean that they were able to prove noninferiority given the small sample size. Last, the authors evaluated multiple outcomes at different times, but they did not adjust their analysis to avoid Type I errors. I would welcome comments by the authors as this would provide further support of their findings of this important clinical trial.
{"title":"Re: \"A Prospective Randomized Comparative Clinical Trial to Analyze Pain and Surgical Outcomes Between Frontal Nerve Blocks and Subconjunctival Anesthesia for Conjunctival Mullerectomy Resection\".","authors":"A. Putterman","doi":"10.1097/IOP.0000000000001389","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001389","url":null,"abstract":"To the Editor: I read with great interest the article of Zatezalo et al. in a recent issue of the journal. The authors performed a randomized trial on 33 patients undergoing conjunctival Müller’s muscle resection and concluded that there was no statistically significant difference in pain scores or surgical outcomes in patients receiving frontal nerve block compared with those receiving subconjunctival injection. The authors should be congratulated for performing a well-designed study in an important topic (e.g., acute pain) in patients undergoing surgical procedures. The current emphasis on the need to reduce the use of opioids makes the topic very relevant in perioperative medicine. Although the study of Zatezalo et al. was well conducted, there are several questions regarding the study that need to be clarified to further confirm the validity of the results. First, it is unclear if the authors standardized the intraoperative and postoperative analgesic regimens as this can significantly affect the study results. Second, the authors did not detect a difference on pain scores, but it does not mean that they were able to prove noninferiority given the small sample size. Last, the authors evaluated multiple outcomes at different times, but they did not adjust their analysis to avoid Type I errors. I would welcome comments by the authors as this would provide further support of their findings of this important clinical trial.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"97 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77800802","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 : 2019-05-01DOI: 10.1097/iop.0000000000001388
C. Zatezalo, M. Tavakoli, J. ayala-haedo, M. Ko, Apostolos G Anagnostopoulos, Elizabeth A. Vanner, Wendy W. Lee
{"title":"Reply re: \"A Prospective Randomized Comparative Clinical Trial to Analyze Pain and Surgical Outcomes Between Frontal Nerve Blocks and Subconjunctival Anesthesia for Conjunctival Mullerectomy Resection\".","authors":"C. Zatezalo, M. Tavakoli, J. ayala-haedo, M. Ko, Apostolos G Anagnostopoulos, Elizabeth A. Vanner, Wendy W. Lee","doi":"10.1097/iop.0000000000001388","DOIUrl":"https://doi.org/10.1097/iop.0000000000001388","url":null,"abstract":"","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88825299","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 : 2019-05-01DOI: 10.1097/IOP.0000000000001371
Kristen E. Dunbar, M. Kazim
1. Dunbar KE, Abascal C, Pandit SA, et al. A simple quantitative measure of orbital compliance. Ophthalmic Plast Reconstr Surg 2018;34:560–1. 2. Francis IC, Loughhead JA. Bell’s phenomenon. A study of 508 patients. Aust J Ophthalmol 1984;12:15–21. 3. Braley AE. Malignant exophthalmos. Am J Ophthalmol 1953;36: 1286–90. 4. Ghabrial R, Francis IC, Fulcher GR. Transient retinal arterial compromise in Graves’ orbitopathy. Eye (Lond) 1998;12(pt 3a): 477–9. 5. Frueh BR, Musch DC, Grill R, et al. Orbital compliance in Graves’ eye disease. Ophthalmology 1985;92:657–65. 6. Langenhan F. Instrumentelle Messung der Zurückdrängbarkeit des Augapfels in die Augenhöhle. Z Augenheilkd 1910;24:417–23. 7. Nanda T, Dunbar KE, Campbell AA, et al. Greater proptosis is not associated with improved compressive optic neuropathy in thyroid eye disease. Ophthalmic Plast Reconstr Surg 2018;34(4S suppl 1): 72–4.
1. 邓巴KE, Abascal C, Pandit SA，等。轨道顺应性的简单定量测量。眼科整形外科，2018;34:56 - 1。2. Francis IC, Loughhead JA。贝尔的现象。一项对508名患者的研究。中华眼科杂志1984;12:15-21。3.Braley AE。恶性眼球突出。中华眼科杂志，1993;36:1286-90。4. 王晓明，王晓明，王晓明。一过性视网膜动脉损伤与Graves眼病的关系。Eye (long) 1998;12(pt 3a): 477-9。5. Frueh BR, Musch DC, Grill R，等。Graves眼病的眼眶顺应性眼科1985;92:657 - 65。6. 王志强。仪器学报Zurückdrängbarkeit des Augapfels in die Augenhöhle。[j]中华医学杂志，1910;24:417-23。7. Nanda T, Dunbar KE, Campbell AA，等。较大的眼球突出与甲状腺眼病压缩性视神经病变的改善无关。眼科整形外科2018;34(增刊1):72-4。
{"title":"Reply Re: \"Accuracy of Simple Quantitative Assessment of Orbital Resiliency\".","authors":"Kristen E. Dunbar, M. Kazim","doi":"10.1097/IOP.0000000000001371","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001371","url":null,"abstract":"1. Dunbar KE, Abascal C, Pandit SA, et al. A simple quantitative measure of orbital compliance. Ophthalmic Plast Reconstr Surg 2018;34:560–1. 2. Francis IC, Loughhead JA. Bell’s phenomenon. A study of 508 patients. Aust J Ophthalmol 1984;12:15–21. 3. Braley AE. Malignant exophthalmos. Am J Ophthalmol 1953;36: 1286–90. 4. Ghabrial R, Francis IC, Fulcher GR. Transient retinal arterial compromise in Graves’ orbitopathy. Eye (Lond) 1998;12(pt 3a): 477–9. 5. Frueh BR, Musch DC, Grill R, et al. Orbital compliance in Graves’ eye disease. Ophthalmology 1985;92:657–65. 6. Langenhan F. Instrumentelle Messung der Zurückdrängbarkeit des Augapfels in die Augenhöhle. Z Augenheilkd 1910;24:417–23. 7. Nanda T, Dunbar KE, Campbell AA, et al. Greater proptosis is not associated with improved compressive optic neuropathy in thyroid eye disease. Ophthalmic Plast Reconstr Surg 2018;34(4S suppl 1): 72–4.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85348613","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 : 2019-05-01DOI: 10.1097/IOP.0000000000001367
R. Medel, L. Vasquez, J. C. Sánchez España
To the Editor: I thank Dr. Putterman for his comments on our recent publication. For me it is a pride that he has read our work and took the time to make suggestions, which I appreciate and respect. As he commented, we have a relatively large percentage of reoperations, about 50% of 24 patients treated with super maximum resection/Whitnall sling. Keep in mind that this reoperation result is after a follow up of 10 years, and as we understand Dr. Putterman’s fantastic work, of 8 patients in the group of super maximum resection associating a Tarsectomy (T) (Table 4, group I), only 1 patient required reoperation according his criteria. But based on our criteria, 4 patients would have required reoperation (2.5, 2.5, 3, 2 mm of postoperative ptosis), which means half of the patients of the entire group (just like our 50% of revision surgery in our work). Nevertheless, we could not see the evolution in time of the patients in Dr. Putterman’s study, and to have a good comparison of both techniques/groups, it would be interesting to have similar follow-up times. Another difference in our study is that all 71 cases were operated on with an age younger than 2 years old. In Dr. Putterman’s work, we only can find 2 cases younger than 2 years old and these were included in the non-Tarsectomy group (Table 4, group II). I want to thank Dr. Putterman for the recommendation to perform a Tarsectomy associated with super maximum resection. This is a valuable contribution to the ptosis surgeon community. The aim of our study was just to evaluate the reoperation rate of a new technique (frontalis muscle flap) with a wellknown technique (super maximum resection) under the same conditions (same surgeon, same reoperation criteria) and in a homogenous age group of patients. I believe the technique we developed for frontalis muscle flap, in appropriate hands, is safer with less morbidity, less complications, and less reoperation rates than any other technique for patients with severe congenital ptosis having very poor levator muscle function. I appreciate again the cordial suggestion and wish to thank Dr. Putterman for his invaluable contributions to ptosis surgery. I am willing to respond to any new concerns regarding this issue. Ramón Medel, MD. Luz María Vasquez, M.D. Juan Carlos Sánchez España, M.D., Ph.D.
致编辑:我感谢Putterman博士对我们最近出版的文章的评论。对我来说，他阅读了我们的工作并花时间提出建议是一种骄傲，我对此表示赞赏和尊重。正如他所说，我们的再手术比例相对较高，24例患者中约有50%接受了超级最大切除/Whitnall吊带手术。请记住，这个再手术的结果是在10年的随访之后，正如我们所理解的Putterman博士的出色工作，在超级最大切除联合跗骨切除术(T)组的8名患者中(表4，组I)，根据他的标准，只有1名患者需要再手术。但根据我们的标准，4例患者需要再次手术(术后上睑下垂2.5、2.5、3、2 mm)，这意味着整个组的一半患者(就像我们工作中50%的翻修手术)。然而，在Putterman博士的研究中，我们无法看到患者在时间上的变化，为了对两种技术/组进行很好的比较，如果有类似的随访时间将会很有趣。本研究的另一个不同之处在于，所有71例患者的手术年龄都小于2岁。在Putterman博士的工作中，我们只发现了2例小于2岁的病例，这些病例被纳入了非跗骨切除术组(表4,II组)。我要感谢Putterman博士建议进行跗骨切除术并进行超最大切除术。这是对上睑下垂外科社区的一个有价值的贡献。我们研究的目的只是在相同的条件下(相同的外科医生，相同的再手术标准)，在相同的年龄组患者中，评估一种新技术(额肌瓣)与一种知名技术(超级最大切除)的再手术率。我相信我们开发的额肌瓣技术，在适当的情况下，比其他任何技术更安全，发病率更低，并发症更少，再手术率也更低对于重度先天性上睑下垂提上睑肌功能很差的患者。我再次感谢他的诚恳建议，并感谢Putterman医生对上睑下垂手术的宝贵贡献。我愿意对有关这个问题的任何新的关切作出回应。Ramón Medel, MD, Luz María Vasquez, M.D.， Juan Carlos Sánchez España, M.D.， Ph.D。
{"title":"Reply re: \"Frontalis Muscle Flap Versus Maximum Anterior Levator Resection as the First Option for Patients With Severe Congenital Ptosis\".","authors":"R. Medel, L. Vasquez, J. C. Sánchez España","doi":"10.1097/IOP.0000000000001367","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001367","url":null,"abstract":"To the Editor: I thank Dr. Putterman for his comments on our recent publication. For me it is a pride that he has read our work and took the time to make suggestions, which I appreciate and respect. As he commented, we have a relatively large percentage of reoperations, about 50% of 24 patients treated with super maximum resection/Whitnall sling. Keep in mind that this reoperation result is after a follow up of 10 years, and as we understand Dr. Putterman’s fantastic work, of 8 patients in the group of super maximum resection associating a Tarsectomy (T) (Table 4, group I), only 1 patient required reoperation according his criteria. But based on our criteria, 4 patients would have required reoperation (2.5, 2.5, 3, 2 mm of postoperative ptosis), which means half of the patients of the entire group (just like our 50% of revision surgery in our work). Nevertheless, we could not see the evolution in time of the patients in Dr. Putterman’s study, and to have a good comparison of both techniques/groups, it would be interesting to have similar follow-up times. Another difference in our study is that all 71 cases were operated on with an age younger than 2 years old. In Dr. Putterman’s work, we only can find 2 cases younger than 2 years old and these were included in the non-Tarsectomy group (Table 4, group II). I want to thank Dr. Putterman for the recommendation to perform a Tarsectomy associated with super maximum resection. This is a valuable contribution to the ptosis surgeon community. The aim of our study was just to evaluate the reoperation rate of a new technique (frontalis muscle flap) with a wellknown technique (super maximum resection) under the same conditions (same surgeon, same reoperation criteria) and in a homogenous age group of patients. I believe the technique we developed for frontalis muscle flap, in appropriate hands, is safer with less morbidity, less complications, and less reoperation rates than any other technique for patients with severe congenital ptosis having very poor levator muscle function. I appreciate again the cordial suggestion and wish to thank Dr. Putterman for his invaluable contributions to ptosis surgery. I am willing to respond to any new concerns regarding this issue. Ramón Medel, MD. Luz María Vasquez, M.D. Juan Carlos Sánchez España, M.D., Ph.D.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81595772","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 : 2019-05-01DOI: 10.1097/IOP.0000000000001370
Brendon W. H. Lee, Melvin L. H. Ling, I. Francis
1. Medel R, Vasquez L, Wolley Dod C. Early frontalis flap surgery as first option to correct congenital ptosis with poor levator function. Orbit 2014;33:164–8. 2. Vasquez LM, Alonso T, Medel R. Direct frontalis flap with and without levator pulley for correction of severe ptosis with poor levator function in the same patient. Orbit 2012;31:102–6. 3. Medel R, Alonso T, Giralt J, et al. Frontalis muscle flap advancement with a pulley in the levator aponeurosis in patients with complete ptosis and deep-set eyes. Ophthalmic Plast Reconstr Surg 2006;22: 441–4. 4. Medel Jiménez R, Sánchez España JC, Visa Nassarre J, et al. Transcaruncular rectus tendon fixation to the orbit and frontalis flap for complete third nerve palsy. Orbit 2018;15:1–6.
1. Medel R, Vasquez L, Wolley Dod C.早期额肌瓣手术作为纠正先天性上睑下垂并提上睑肌功能差的首选。轨道2014;33:164-8。2. Vasquez LM, Alonso T, Medel R.带和不带提上提肌滑轮的直接额肌瓣矫正同一患者重度上睑下垂并提上提肌功能差。轨道2012;31:102-6。3.刘建军，刘建军，刘建军，等。带滑轮的额肌瓣推进提上睑肌筋膜对完全性上睑下垂及深陷眼患者的影响。眼科整形外科2006;22:441 - 441。4. 金文杰，Sánchez España，等。经肩胛直肌肌腱眶部及额肌瓣固定治疗完全性第三神经麻痹。轨道2018;15:1-6。
{"title":"Re: \"Accuracy of Simple Quantitative Assessment of Orbital Resiliency\".","authors":"Brendon W. H. Lee, Melvin L. H. Ling, I. Francis","doi":"10.1097/IOP.0000000000001370","DOIUrl":"https://doi.org/10.1097/IOP.0000000000001370","url":null,"abstract":"1. Medel R, Vasquez L, Wolley Dod C. Early frontalis flap surgery as first option to correct congenital ptosis with poor levator function. Orbit 2014;33:164–8. 2. Vasquez LM, Alonso T, Medel R. Direct frontalis flap with and without levator pulley for correction of severe ptosis with poor levator function in the same patient. Orbit 2012;31:102–6. 3. Medel R, Alonso T, Giralt J, et al. Frontalis muscle flap advancement with a pulley in the levator aponeurosis in patients with complete ptosis and deep-set eyes. Ophthalmic Plast Reconstr Surg 2006;22: 441–4. 4. Medel Jiménez R, Sánchez España JC, Visa Nassarre J, et al. Transcaruncular rectus tendon fixation to the orbit and frontalis flap for complete third nerve palsy. Orbit 2018;15:1–6.","PeriodicalId":19621,"journal":{"name":"Ophthalmic Plastic & Reconstructive Surgery","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79272011","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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