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Multidisciplinary Frontotemporal Orbitozygomatic Craniotomy for Spheno-orbital Meningiomas: Ophthalmic and Orbital Outcomes
Idowu, Oluwatobi O. M.D.*; Ashraf, Davin C. M.D.*; Magill, Stephen T. M.D., Ph.D.†; Kersten, Robert C. M.D.*; McDermott, Michael W. M.D.†; Vagefi, M. Reza M.D.*
doi : 10.1097/IOP.0000000000001662
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 18-26
Advances in surgical approaches have improved access for total or near-total resection of spheno-orbital meningiomas (SOM). Herein, the outcomes of multidisciplinary resection and reconstruction of SOM via frontotemporal orbitozygomatic craniotomy at a single institution are evaluated.
Incidence and Risk Factors of Moderate to Severe Postoperative Pain Following the Placement of Primary and Secondary Orbital Implants: A Prospective Observational Study
Zhu, Yanling M.D.*,†; Li, Zuohong M.D., Ph.D.†; Chen, Wenshi R.N.†; Fan, Peiting R.N.*,†; Yang, Shiying M.D.*,†; Liu, Xuehua R.N.†; Guo, Wenjun M.D.*,†; Gan, Xiaoliang M.D., Ph.D.*,
doi : 10.1097/IOP.0000000000001664
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 27-32
To prospectively explore the incidence and risk factors of moderate to severe pain after primary and secondary orbital implantation following evisceration or enucleation surgery.
Topical Corticosteroid Use Associated With Increased Degree of Ptosis and Rate of Ptosis Repair Failure
Dermarkarian, Christopher R. M.D.; Williams, Katherine J. M.D.; Sweeney, Adam R. M.D.; Allen, Richard C. M.D., Ph.D.; Yen, Michael T. M.D
doi : 10.1097/IOP.0000000000001671
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 33-37
To compare the degree of ptosis and the risk of ptosis repair failure among patients with and without a history of topical corticosteroid use.
Update on Idiopathic Canalicular Inflammatory Disease (ICID): Outcomes With Addition of Topical Cyclosporine and the Modified Treatment Protocol
Ali, Mohammad Javed M.D., Ph.D., F.R.C.S.; Bothra, Nandini M.D
doi : 10.1097/IOP.0000000000001672
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 38-41
The objective of this study is to present clinical outcomes with addition of topical cyclosporine while managing cases of “idiopathic canalicular inflammatory disease” and to propose a modified treatment protocol.
Conjunctival Implantation Cyst in the Orbicularis Oculi Muscle: Review of a Possible Origin From Displaced Stem Cells With a Differential Diagnosis
Jakobiec, Frederick A. M.D., D.Sc.*; Hanbazazh, Mehenaz M.D.*; Barrantes, Paula Cortes M.D.*; Yoon, Michael K. M.D.†
doi : 10.1097/IOP.0000000000001631
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 1-11
To document a unique case of a corneal/conjunctival epithelial inclusion cyst located in the orbicularis oculi muscle with a comprehensive review of variant conjunctival cysts and simulating conditions.
Postoperative Quality of Life in Oculoplastic Patients
Seo, Shin Tien*; Sundar, Gangadhara D.O., F.R.C.S.Ed., F.A.M.S.†; Young, Stephanie Ming F.A.M.S., F.R.C.Ophth.†
doi : 10.1097/IOP.0000000000001681
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 12-17
To conduct a literature review on postoperative quality of life in oculoplastic patients.
Corneal Neurotization for Postherpetic Neurotrophic Keratopathy: Initial Experience and Clinical Outcomes
Kim, Jane S. M.D.; Rafailov, Leon M.D.; Leyngold, Ilya M. M.D.
doi : 10.1097/IOP.0000000000001676
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 42-50
To assess early outcomes of corneal neurotization for postherpetic neurotrophic keratopathy (NK).
Rapid Rehabilitation With Skin-Muscle Sparing Orbital Exenteration: A Single-Center Series
Jayaprakasam, Anuradha F.R.C.Ophth.; Vahdani, Kaveh M.D., F.R.C.Ophth.; Rose, Geoffrey E. D.Sc., F.R.C.Ophth.; Saleh, George M. M.D., F.R.C.Ophth.; Hussain, Badrul F.R.C.Ophth.; Verity, David H. M.D., F.R.C.Ophth.; Collin, J. Richard O. F.R.C.Ophth.
doi : 10.1097/IOP.0000000000001677
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 51-54
To examine the features and clinical management of patients who underwent skin-muscle sparing orbital exenteration in a tertiary referral center.
Primary Nasocutaneous Fistulae in Granulomatosis With Polyangiitis: A Case Series and Literature Review
Bahrami, Bobak M.B.B.S., Ph.D.*; Curragh, David M.B.B.Ch., F.R.C.Ophth.*; McNab, Alan A. M.B.B.S., D.Med.Sc., F.R.A.N.Z.C.O., F.R.C.Ophth.†; Davis, Garry M.B.B.S., F.R.A.N.Z.C.O.*; Dolman, Peter J. M.D., F.R.C.S.C.‡; Selva, Dinesh M.B.B.S., F.R.A.N.Z.C.O.*
doi : 10.1097/IOP.0000000000001678
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 55-60
To report the presentation, investigation, management, and outcomes of primary nasocutaneous fistulae in granulomatosis with polyangiitis and review the literature of this complication.
The Role of Postoperative Bandage Contact Lens in Patients Undergoing Fasanella-Servat Ptosis Repair
Adam, Robert S. M.D.*; Harvey, John T. M.D.*; Gould, Jonah N. B.MSc., M.MASc.†; Suntheralingam, Sivisan B.MSc.‡; Farrokhyar, Forough Ph.D.§
doi : 10.1097/IOP.0000000000001690
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 61-64
To determine whether a bandage contact lens (BCL) improves patient comfort in the postoperative period in patients undergoing ptosis repair using the Fasanella-Servat technique, compared with no BCL.
Day-Case Admission for External Dacryocystorhinostomy in Preschool Children
Juniat, Valerie FRCOphth; Rose, Geoffrey E. DSc, FRCOphth; Timlin, H. FRCOphth; Wagh, V.J. FRCOphth; Abou-Rayyah, Y. Ph.D, FRCOphth; Uddin, J. FRCOphth; Verity, David H. M.D., FRCOphth
doi : 10.1097/IOP.0000000000001694
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 65-66
Epistaxis during or after dacryocystorhinostomy may present a risk of circulatory compromise, particularly in young children. In view of this concern, we reviewed the outcome and complications of external dacryocystorhinostomy in preschool children, aged less than 4½ years.
Treatment of Congenital Ptosis in Infants With Associated Amblyopia Using a Frontalis Muscle Flap Eyelid Reanimation Technique
Eton, Emily A. M.D.*; Carniciu, Anaïs L. M.D.*,†; Prabhu, Shreya S. M.D., M.P.H.*; Wang, Grace M. M.D., Ph.D.*; Kahana, Alon M.D., Ph.D.*
doi : 10.1097/IOP.0000000000001697
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 67-71
To determine the efficacy of a frontalis muscle flap eyelid reanimation technique for correction of severe congenital ptosis and associated amblyopia in infants.
Blunderbuss: Ocular and Orbital Injuries Due to Muzzle-Loading Firearms
De Niear, Matthew A. M.D., Ph.D.*,†; Law, James J. B.S.*,‡; Breazzano, Mark P. M.D.*,‡,§; Mawn, Louise A. M.D., F.A.C.S
doi : 10.1097/IOP.0000000000001709
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 72-76
Injury to the eye and/or orbital and adnexal structures associated with antiquated muzzle-loading firearms has not, to our knowledge, been characterized with the exception of a single case report.
Adult Versus Pediatric Relapse and Recurrence in Orbital Inflammatory Syndrome
Keen, Jamie A. M.D.*; Kennedy, Brandon J. B.S.†; Mishulin, Aleksey M.D.‡; Winkler, Kathryn M.D.§; Fernandez-Ruiz, Maria M.D.?; Black, Evan H. M.D., F.A.C.S.*,¶; Roarty, John M.D.
doi : 10.1097/IOP.0000000000001705
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 77-80
Orbital inflammatory syndrome (OIS) is a diagnosis of exclusion that has a variable presentation and unpredictable course. Many studies report incomplete or lack of OIS resolution with high recurrence and relapse rates. No studies to date have investigated the characteristics of both recurrence and relapse in OIS. We sought to determine this in both pediatric and adult patients.
Utilizing 3D-Printed Orbital Floor Stamps to Create Patient-Specific Implants for Orbital Floor Reconstruction
Prabhu, Shamit S. M.S.*; Chung, Scotty A. M.S.†; Brown, Philip J. Ph.D.†; Runyan, Christopher M. M.D., Ph.D.‡
doi : 10.1097/IOP.0000000000001734
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 81-85
This study seeks to test a novel technique of custom-printed midface contour models with orbital floor “stamps” to guide reconstruction of orbital floor blowout fractures, with or without concomitant zygomaticomaxillary complex injury.
Adjustable Ptosis Correction via Posterior Levator Advancement With Minimal Superior Tarsectomy
Tran, Ann Q. M.D.*†‡; DeMaria, Lauren N. M.D.†; Nair, Archana A. M.D.†; Tooley, Andrea A. M.D.*,†,‡; Godfrey, Kyle J. M.D.‡; Lisman, Richard D. M.D., F.A.C.S.
doi : 10.1097/IOP.0000000000001772
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 86-90
To report the surgical technique and outcomes for adjustable ptosis correction using a posterior levator advancement with minimal superior tarsectomy.
Teleoculoplastics-Teleorbit During COVID-19 Pandemic
Garrido-Hermosilla, Antonio M. M.D.; Palenque-S?nchez, Javier M.D.; D?az-Ruiz, Mar?a Concepci?n M.D
doi : 10.1097/IOP.0000000000001822
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 91
A Customized Face-Shield for Ophthalmologists During COVID-19 Second Wave
Montericcio, Alberto M.D.; Montericcio, Alessio M.D.; Raimondi, Raffaele M.D.
doi : 10.1097/IOP.0000000000001900
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 91-92
Re: “Loss of Stimulated Tear Secretion After Orbital Reconstruction”
Yang, Fan Ph.D., M.D.; Li, Zhengkang M.D.; Deng, Yuan Ph.D., M.D.
doi : 10.1097/IOP.0000000000001878
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 92-94
Reply re: “Loss of Stimulated Tear Secretion After Orbital Reconstruction”
Madhan, Nayasha S. M.D.; Cho, Raymond I. M.D., F.A.C.S.
doi : 10.1097/IOP.0000000000001879
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 94-95
Re: “Prognostic Factors for Orbital Exenteration, Local Recurrence, Metastasis, and Death From Disease in Conjunctival Squamous Cell Carcinoma”
Kashkouli, Mohsen Bahmani M.D.; Jafarpour, Soheyla M.D
doi : 10.1097/IOP.0000000000001904
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 95
Reply re: “Prognostic Factors for Orbital Exenteration, Local Recurrence, Metastasis, and Death From Disease in Conjunctival Squamous Cell Carcinoma”
Esmaeli, Bita M.D., F.A.C.S.
doi : 10.1097/IOP.0000000000001905
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 95-96
Re: “Orbital Myositis: A Comprehensive Review and Reclassification”
Lam, Danny M.M.ed.; Francis, Ian C. Ph.., F.R.A.N.Z.C.O., F.R.A.C.S.
doi : 10.1097/IOP.0000000000001919
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 96
Reply re: “Orbital Myositis: A Comprehensive Review and Reclassification”
McNab, Alan A. D.Med.Sc., F.R.A.N.Z.C.O.
doi : 10.1097/IOP.0000000000001920
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 96
Re: “Acute Spontaneous Rupture of the Superior Ophthalmic Vein”
Rootman, Daniel B. M.D., M.S.; Feldman, Ken A. M.D
doi : 10.1097/IOP.0000000000001896
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 96-97
Re: “Acute Spontaneous Rupture of the Superior Ophthalmic Vein”
Rose, Geoffrey E. D.Sc., F.R.C.Ophth.; Vahdani, Kaveh M.D., F.R.C.Ophth.
doi : 10.1097/IOP.0000000000001897
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 98
Re: “Morbihan Syndrome, a UK Case Series. What’s in a Name?”
McNab, Alan A. DMedSc, FRANZCO
doi : 10.1097/IOP.0000000000001893
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 98
Aesthetic Abstracts
Burroughs, John M.D.*; Hwang, Catherine J. M.D.†; Nakra, Tanuj M.D.‡,§; Rootman, Daniel B. M.D.?; Wulc, Allan M.D., F.A.C.S.¶; Woodward, Julie M.D.#
doi : 10.1097/IOP.0000000000001907
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 99-101
Oculoplastic Abstracts
Ali, M. Javed M.D.*; Bernardini, Francesco M.D.†; Esmaeli, Bita M.D.‡; McNab, Alan M.D.§; Tawfik, Hatem M.D.?
doi : 10.1097/IOP.0000000000001901
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p 102-104
Orbital and Eyelid Inflammation With “Muciphages” and Extravasated Mucin From an Ethmoido-orbital Mucocele
Dempsey, Katharine S. M.D.*; Tooley, Andrea A. M.D.*; Patel, Payal J. M.D.*; Charles, Norman C. M.D.*,†; Belinsky, Irina M.D.
doi : 10.1097/IOP.0000000000001685
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p e1-e3
A 22-year-old woman presented with an acute compressive optic neuropathy due to a ruptured ethmoido-orbital mucocele. She underwent urgent orbital decompression and drainage of the mucocele via an endoscopic approach. Postoperatively, her course was complicated by an orbital compartment syndrome supervened, exhibiting severe eyelid edema caused by infiltration with mucin and mucin-containing macrophages (“muciphages”). Biopsy of the eyelid showed infiltration with “muciphages,” macrophages laden with extravasated mucinous material. This is the first report that documents the clinical and histopathologic course of orbital inflammation following mucocele extravasation into the orbit and eyelids.
Conjunctival Lymphoma With Nasal Spread Through the Nasolacrimal Duct
Young, William B.S.*; Scofield-Kaplan, Stacy M. M.D.*; Levy, R. Evan M.D.*; Rosado, Flavia M.D.†; Mancini, Ronald M.D., F.A.C.S.*
doi : 10.1097/IOP.0000000000001692
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p e3-e5
Conjunctival mucosa-associated lymphoid tissue lymphoma classically presents as a subconjunctival mass, most often in the fornix. The presence of conjunctival mucosa-associated lymphoid tissue lymphoma with spread down the nasolacrimal duct has only been reported once previously. The authors present a case of a 35-year-old woman with a right conjunctival mass in the inferior fornix along with sinus congestion and fullness. A biopsy of the conjunctival mass and the nasal turbinate revealed a conjunctival mucosa-associated lymphoid tissue lymphoma. Therefore, it is important to consider spread down the nasolacrimal duct in patients with conjunctival lymphoma also presenting with difficulty breathing or nasal congestion.
Malignant Phyllodes Tumor of the Breast With Metastasis to the Orbit: A Rare Case Report
Vempuluru, Vijitha S M.D.*; Mishra, Dilip K M.D.†; Kaliki, Swathi M.D.*
doi : 10.1097/IOP.0000000000001693
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p e5-e7
Phyllodes tumors are rare and account for 0.5% of all mammary neoplasms. They commonly present as lobulated breast tumors and have a variable clinical course. Histologically, phyllodes tumor is composed of 2 major elements: stromal element composed of spindle cells admixed with collagen and epithelial element in the form of epithelium lined cysts and clefts. Metastasis is rarely seen with phyllodes tumors. Sarcomatous component of phyllodes tumor metastasizes to lung, liver, adrenal, brain, and bones by hematogenous route. A thorough literature search did not reveal any report of orbital metastasis from malignant phyllodes tumor. Here, the authors describe a rare case of malignant phyllodes tumor of the breast with metastasis to the orbit in a 46-year-old female patient.
Spontaneous Orbital Wall Decompression in Thyroid Eye Disease: A Rare Feature
Vasanthapuram, Varshitha Hemanth M.D.; Naik, Milind N M.D.
doi : 10.1097/IOP.0000000000001696
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p e7-e9
Spontaneous orbital decompression is an incidental radiological finding in patients of thyroid eye disease. It is rare with few case reports in ophthalmic literature. The authors describe a 48-year-old female with thyroid eye disease who was found to have a spontaneous orbital decompression on computed tomography imaging.
Immune Checkpoint Inhibitor Therapy as an Eye-Preserving Treatment for Locally Advanced Conjunctival Melanoma
Hong, Bennett Yau-Bun M.D.*,†; Ford, Joshua R. M.D.*; Glitza, Isabella C. M.D., Ph.D.‡; Torres Cabala, Carlos A. M.D.§; Tetzlaff, Michael M.D., Ph.D.§; Prieto, Victor G. M.D., Ph.D.§; Parker, Richard M.D.?; Daniel, Claire M.D.?; Esmaeli, Bita M.D.
doi : 10.1097/IOP.0000000000001700
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p e9-e13
The authors present 2 patients with locally advanced conjunctival melanoma for whom definitive surgery would mean an orbital exenteration with its associated inherent total visual loss and major facial disfigurement. Instead both patients were treated with immune checkpoint inhibitor therapy. In 1 patient neoadjuvant pembrolizumab was used for approximately 12 months and the patient experienced near-total clinical resolution of the conjunctival melanoma. Multiple surgical biopsies of very small residual pigmentation showed pigmented macrophages and a complete pathologic response. In the second patient who presented with a locally advanced and metastatic conjunctival melanoma, significant shrinkage of conjunctival mass was observed after treatment with a combination of ipilimumab and nivolumab for 5 months, and this allowed preservation of the eye and ocular function.
Eye-sparing Treatment of Localized Orbital Medulloepithelioma With Neoadjuvant Chemoradiation
Gallo, Ryan A. B.A.*; Shoag, Jamie M.D.†; Johnson, Thomas E. M.D.*; Solomon, David A. M.D., Ph.D.‡; Perry, Arie M.D.‡; Podda, Antonello M.D.†; Lee, John Y. B.A.*; Rong, Andrew J. M.D.*
doi : 10.1097/IOP.0000000000001703
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p e13-e16
A 9-year-old girl presented with a 3-day history of progressive proptosis accompanied by transient discomfort and blurry vision in the OD. MRI revealed a heterogeneously enhancing intraconal lesion that partially encased and displaced the optic nerve. There was no intraocular or intracranial involvement, nor were there signs of distant metastasis. Histopathologic evaluation and immunohistochemistry were consistent with orbital medulloepithelioma. The patient received 4 cycles of chemoradiation per a retinoblastoma protocol. Repeat MRI scans showed significant tumor regression, and further surgical debulking was performed. There has been no evidence of recurrence for over 14 months. Herein, the authors describe an eye-sparing, multimodal treatment of a rare case of localized orbital medulloepithelioma.
Orbital Floor Implant Causing Loss of Parasympathetic Lacrimal Gland Innervation
Madhan, Nayasha S. M.D.; Cho, Raymond I. M.D., F.A.C.S.
doi : 10.1097/IOP.0000000000001704
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p e16-e17
Many postoperative complications are known to occur as a result of orbital floor fracture repair, but loss of lacrimal gland function has not been reported. The authors present a patient who lost reflex tearing after undergoing orbital floor fracture repair by an outside surgeon. CT scan showed placement of the posterolateral edge of the implant through the inferior orbital fissure, which presumably transected the parasympathetic fibers innervating the lacrimal gland.
Chronic Conjunctival Chemosis—A New Ocular Side Effect of Crizotinib
Das, Joyeeta M.B.B.S., D.N.B.*; Das, Nibedita D.N.B., F.I.C.O., M.R.C.S.Ed.†
doi : 10.1097/IOP.0000000000001710
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p e18-e21
Crizotinib, a targeted molecular therapy drug which inhibits tyrosine kinase, is approved for treatment of non-small cell lung carcinoma which has some ocular side effects like photopsia and delayed dark adaptation.This report documents a unique case of persistent conjunctival chemosis likely due to side effects of crizotinib therapy. A 64-year-old gentleman on crizotinib for metastatic adenocarcinoma of the lung presented with conjunctival chemosis in right eye which appeared 1 month after uneventful clear corneal phacoemulsification surgery. The patient was on crizotinib 250?mg twice a day started 2 months before cataract surgery. Clinical examination revealed marked inferior bulbar conjunctival edema of the right eye. Anterior segment optical coherence tomography, slit-lamp photographs, and magnetic resonance imaging orbit and systemic investigation were done to rule out other causes of conjunctival edema. Magnetic resonance imaging shows conjunctival and preseptal edema around both eye and thinning of the optic nerve in the right eye. Anterior segment optical coherence tomography revealed elevated hyper-reflective thickened conjunctival layer with dilated empty thin wall dark spaces of varying caliber. Chemosis was persisted for the next 3 months and not responded to oral acetazolamide, topical steroid and decongestive eyedrops. After 3 months, crizotinib was discontinued by oncologist due to drug intolerance and surprisingly within 1 week, the conjunctival edema was disappeared totally. To the best of the authors' knowledge, this is the first reported case of persistent unilateral non-inflammatory conjunctival chemosis caused by crizotinib. The physicians should be vigilant about these complications.
Radiation-Induced Hyalinizing Clear Cell Carcinoma of the Orbit
Topping, Katie L. M.D.*; Ortiz, Angelica M.D.†; Lin, Jonathan H. M.D., Ph.D.†; Kossler, Andrea L. M.D.
doi : 10.1097/IOP.0000000000001708
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p e21-e23
Radiation-induced malignancy is rare, occurring in approximately 0.4%–1.0% of patients receiving external beam radiation therapy. Sarcomas and squamous cell carcinomas are among the most common types of cancers to occur. A 74-year-old woman presented with redness and swelling in the right periorbital region. She had history of multiple recurrent ameloblastoma of the right maxilla, invading the right orbital floor status post 4 surgical resections and 66 Gray external beam radiotherapy 5 years prior. MRI showed a poorly circumscribed mass involving the inferior and lateral orbit. Orbital biopsy revealed clear cell carcinoma with hyalinizing sclerosis and Ewing sarcoma breakpoint region 1 gene arrangement. Due to the extent of orbital disease and presence of perineural invasion, she underwent orbital exenteration. Hyalinizing clear cell carcinoma, a rare cancer, has not been reported to occur in the orbit following radiation. This case highlights the importance of lifetime monitoring in patients who have undergone radiation therapy.
A Simple Bone Cyst Requiring Exenteration: A Case Report With Literature Review
Yi Wen, Lim M.B.B.S.*; Singh, Sujaya M.B.B.S., M.S.Ophth.*; Mohamad, Nor Fadhilah Binti N.H.N.N., M.S.Ophth.*; Toh, Yen-Fa M.D., M.Path.†; Khalil, Alizan Abdul Khalil M.B.B.S., F.R.C.S., M.Med., Ph.D.
doi : 10.1097/IOP.0000000000001713
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p e23-e25
Simple bone cyst is a benign osteolytic lesion, found primarily in the mandible, occasionally in the maxilla, and rarely in the zygoma. A 17-year-old male patient with 6-month history of left facial mass presented with worsening proptosis and displacement of left eyeball associated with reduced OS vision. The lesion was painless to start with, but with time, he reported OS pain. There was no history of any trauma. CT scan and MRI of orbit performed revealed cystic bony lesion involving greater wing of sphenoid. He subsequently had excision of the left facial mass with exenteration of OS due to poor visual prognosis, followed by reconstruction with osteomyocutaneous flap from left scapular region. The histopathologic features were consistent with a diagnosis of simple bone cyst of zygomatic arch.
Posttraumatic Respiratory Epithelial Orbital Cyst With Intracranial Extension: A Unique Association
Theofilou, Nantia-Eleni M.D., D.M.D.*; Becker, Minerva M.D.†; Lombardi, Tommaso M.D., D.M.D.‡; Scolozzi, Paolo M.D., D.M.D.§
doi : 10.1097/IOP.0000000000001714
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p e25-e28
Respiratory epithelial orbital cysts (REOC) are rare benign lesions that may be either congenital or acquired. Congenital REOC develop from embryological epithelial rests and are known as choristomas, whereas acquired forms develop from the sequestration of respiratory epithelium from adjacent paranasal sinuses following trauma and/or fracture repair procedures. The final diagnosis can be difficult because congenital and acquired REOC and mucoceles share the same features histologically. The involvement of the paranasal sinuses, which is the landmark of mucoceles, does not occur with REOC. Moreover, the intracranial extension, which is known for mucoceles, has never been reported for REOC. Respiratory epithelial orbital cysts warrant prompt radical surgical resection given that these lesions may lead to a progressive intracranial progression and/or recurrent infection with a potential for meningitis or cerebral abscess. The authors report a unique case of a patient with an intraorbital posttraumatic respiratory epithelial orbital cyst associated with intracranial involvement.
Bilateral Leukemic Infiltration of the Lacrimal Sac in a Child
Levitt, Alexandra E. M.D., M.P.H.; Choi, Catherine J. M.D., M.S.; Johnson, Thomas E. M.D
doi : 10.1097/IOP.0000000000001718
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p e28-e30
An 8-year-old boy with a history of refractory acute lymphoblastic leukemia presented with left-sided periorbital erythema and painless enlargement of the lacrimal sac. MRI revealed a soft tissue mass on the floor of the left orbit, extending into the nasolacrimal sac and duct. Lacrimal sac biopsy was consistent with B-lymphoblastic leukemia. The patient was treated with chemotherapy and radiation with satisfactory remission of local disease. However, similar symptoms emerged shortly after on the contralateral side, and repeat MRI was concerning for new leukemic infiltration of the right lacrimal sac. Bone marrow biopsy revealed concurrent medullary relapse. Systemic chemotherapy was adjusted and radiation therapy of the right orbit was initiated. This is the first reported pediatric case of bilateral leukemic involvement of the lacrimal sac.
Necrotizing Granulomatous Dacryoadenitis With Non-Necrotizing Granulomatous Scar Hypertrophy: Two Histological Variants of Sarcoidosis in the Same Patient
Godbout, Erin E. M.D.*; Subik, M. Kristina M.D.†; Rubinstein, Tal J. M*,‡
doi : 10.1097/IOP.0000000000001720
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p e30-e33
Orbital involvement with histologic necrosis is a rare manifestation of systemic sarcoidosis. The authors present a case of necrotizing dacryoadenitis in addition to non-necrotizing granulomas in a hypertrophic scar that is consistent with a diagnosis of sarcoidosis. A 60-year-old female presented with 2 months of painless right upper eyelid fullness and ptosis. CT imaging demonstrated right greater than left lacrimal gland enlargement. A biopsy demonstrated necrotizing granulomatous inflammation of the lacrimal gland. Additional workup was negative for infectious or lymphoproliferative disease. On further investigation, the patient noted thickening of a longstanding abdominal scar, and a subsequent punch biopsy of the scar demonstrated non-necrotizing granulomas suggestive of scar sarcoidosis. CT chest identified mediastinal lymphadenopathy. A diagnosis of sarcoidosis was determined. The authors thereby present an unusual case of 2 histologic variants of sarcoidosis presenting with necrotizing granulomatous dacryoadenitis and non-necrotizing scar granulomas.
Orbital Microscopic Polyangiitis With Secondary Angle Closure Due to Uveal Effusion
Sheils, Catherine R. M.D.; Cypen, Sanja G. M.D.; Bhatter, Param B.S.; Tao, Jeremiah P. M.D., F.A.C.S.
doi : 10.1097/IOP.0000000000001725
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p e33-e35
A 63 year-old man presented with 3 weeks of worsening, painless left-sided proptosis, ptosis, and diplopia. Examination of the affected eye revealed normal visual acuity, normal intraocular pressure in the presence of a shallow anterior chamber, grade 1 relative afferent pupillary defect, restricted motility in all directions of gaze, and 6?mm of proptosis. Ultrasound biomicroscopy revealed uveal effusions with anterior rotation of the ciliary body causing appositional angle closure. B-scan ultrasonography and MRI demonstrated enhancement of the posterior globe and an infiltrative mass involving the lacrimal gland and multiple extraocular muscles. Laboratory studies revealed positive perinuclear antineutrophil cytoplasmic antibody with elevated myeloperoxidase antibodies, consistent with a diagnosis of microscopic polyangiitis. Biopsy showed nonspecific dacryoadenitis. Intravenous and oral corticosteroids were associated with rapid improvement of all examination findings. The patient was later switched to rituximab steroid-sparing therapy and has shown no recurrence of disease at 3-months follow-up.
Giant Eyelid Hemangioma With Ulceration
Pauly, Marian M.S.; Ananthakrishna, Sushma M.S.
doi : 10.1097/IOP.0000000000001606
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p e36
Orbital Aneurysmal Bone Cyst in a Patient With McCune-Albright Syndrome
Sweeney, Adam R. M.D.; Allen, Richard C. M.D., Ph.D., F.A.C.S.
doi : 10.1097/IOP.0000000000001650
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p e37
Temporalis Muscle Abscess With Secondary Extension Into the Orbit
Liou, Victor M.D.; Lee, Nahyoung Grace M.D.
doi : 10.1097/IOP.0000000000001665
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p e38
Ophthalmic Consequences of Ichthyosis and the Role of Systemic Retinoids
Watson, Alison H M.D.*; Amato, Malena M. M.D.†; Popham, Jerry M.D.‡
doi : 10.1097/IOP.0000000000001666
Ophthalmic Plastic and Reconstructive Surgery: January/February 2021 - Volume 37 - Issue 1 - p e39
