Ophthalmology clinics of North America最新文献

Injectable fillers have become an important component of minimally invasive facial rejuvenation modalities. Their ease of use, effectiveness, low morbidity, and fast results with minimal downtime are factors that have made them popular among patients. Soft tissue augmentation has evolved to a unique combination of medicine and art. A wide selection of available agents and new products, each one with unique properties, may be used alone or in combination. The physician acquires the tools to rebalance facial characteristics not only by filling wrinkles but also by having the ability to shape the face and restore bony contours and lines. Careful selection of candidates, realistic expectations, and an understanding of the limitations of fillers are crucial for a successful result.

This article provides an overview of upper eyelid anatomy and racial variations, functional indications in upper lid blepharoplasty, and various surgical techniques.

This article discusses endoscopic foreheadplasty for rejuvenation of the aging face.

A multitude of techniques exists for facelift surgery (rhytidectomy). These techniques range from simple skin undermining to complex procedures involving superficial musculoaponeurotic system (SMAS) manipulation and subperiosteal dissection. Most surgeons agree that some type of modification of the SMAS is necessary to achieve an acceptable result. The technique presented herein involves developing a relatively large skin flap, tightening the SMAS, and redraping the skin.

This article describes the nonablative laser and light source technologies that are currently available for the rejuvenation of photodamaged skin. A brief overview of the etiology of solar skin damage is followed by an explanation of how nonablative technologies induce repair of photoaged skin. An overview of the various light sources is provided, with particular attention to their mechanism of action and clinical use.

This article discusses ablative resurfacing, which is a powerful tool for rejuvenation of the aging face and treatment of a wide array of skin lesions. In the proper hands, it is a safe and effective way to treat many of the problems of photodamaged skin that surgery or nonablative methods cannot address.

Employment of animal models in basic research has significantly advanced the understanding of fundamental processes underlying tumorigenesis in retinoblastoma, including elucidating the complex role of pRb and other related protein products in cell cycle regulation, apoptosis, DNA damage responses, and terminal differentiation. The evolution of therapy for retinoblastoma has also been facilitated through translational research using in vivo models, including xenograft and genetically engineered systems. In retinoblastoma, these models provide a valuable preclinical context for testing the efficacy and safety of conventional chemotherapy, radiotherapy, or novel agents on tumor growth, tissue invasion, and metastasis.

Thermotherapy by the transpupillary route is an effective outpatient eye-salvaging therapy for intraocular tumors. It does not require surgery, it can be repeated, and it does not affect the healthy structures of the eye. Thermotherapy by the transscleral route is under investigation and may have potential in the treatment of choroidal melanomas. The indications for chemoreduction, thermochemotherapy, and thermotherapy for retinoblastoma remain under investigation.

Despite achieving great accuracy in correctly diagnosing uveal melanoma in the United States, mortality owing to this tumor has remained unchanged over a period of 25 years from 1973 to 1997. In general, the survival with metastatic uveal melanoma is poor, with a median survival of less than 6 months.

This article argues the case for the creation of a new group classification of intraocular retinoblastoma. The current Reese-Ellsworth group classification has not been updated since it was published 35 years ago. The proposed classification is based on the natural history of intraocular retinoblastoma and on the risk of loss of the eye following primary therapy.