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Manuscript Reviewers 2020
doi : 10.1097/IOP.0000000000001969
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 105-107
Fate and Management of Incompletely Excised Solitary Fibrous Tumor of the Orbit: A Case Series and Literature Review
Jackson, Chad H. M.D.*; Hunt, Bryan C. M.D.†; Harris, Gerald J. M.D., F.A.C.S.*
doi : 10.1097/IOP.0000000000001691
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 108-117
There is an imperfect correlation between the histology and behavior of solitary fibrous tumor (SFT). In addition, recurrence is common, and dedifferentiation may occur over time. Preferred primary treatment is intact excision, but friable pseudocapsules and tenacious attachments can thwart this goal in the crowded, visually sensitive orbit. This study addresses the fate and appropriate management of incompletely excised orbital SFT.
Orbital Osteomas: Report of 3 Rapidly Progressive Cases in Adolescents and Systematic Literature Review
Tooley, Andrea A. M.D.*; Paulose, Sefy A. B.S.†; Tran, Ann Q. M.D.*; Godfrey, Kyle J. M.D.‡; Kazim, Michael M.D.
doi : 10.1097/IOP.0000000000001755
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 118-124
The purpose of this study was to describe the clinical characteristics, management, and outcomes of orbital osteomas in the pediatric age group, and compare these to osteomas managed in the adult population.
Palpebral Pleomorphic Adenomas of the Lacrimal Gland
Vahdani, Kaveh M.D., F.R.C.Ophth.; Rose, Geoffrey E. D.Sc., F.R.C.Ophth.
doi : 10.1097/IOP.0000000000001682
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 125-128
To report the characteristics and management for patients with palpebral pleomorphic adenoma of the lacrimal gland.
Orbital Lobe and Palpebral Adenomas of the Lacrimal Gland Behave as Distinct Entities
Rose, Geoffrey E. D.Sc., F.R.C.Ophth.; Vahdani, Kaveh M.D., F.R.C.Ophth.
doi : 10.1097/IOP.0000000000001747
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 129-132
To assess whether orbital lobe and palpebral adenomas of the lacrimal gland are biologically similar, based upon a comparison of the age at presentation and at first symptom. The size of the excised tumor in the 2 groups is also examined and considered in relation to age at surgery.
Ophthalmic Surgeries and Systemic Medical Conditions Associated With the Development of Involutional Ptosis
Cohen, Liza M. M.D.*,†; Campbell, Benjamin C. M.D.*; Esfandiari, Mahtash Ph.D.‡; Goldberg, Robert A. M.D.*; Rootman, Daniel B. M.D., M.S.*,†
doi : 10.1097/IOP.0000000000001707
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 133-137
To investigate the associations between systemic medical conditions and types of ocular surgery and the development of aponeurotic ptosis.
Compound Coherent Plane-Wave Ultrasound Imaging of Vascular Malformations of the Orbit
Campbell, Ashley A. M.D.*; Urs, Raksha Ph.D.†; Callahan, Alison B. M.D.‡; Silverman, Ronald H. Ph.D.†; Kazim, Michael M.D
doi : 10.1097/IOP.0000000000001732
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 138-140
Prior color-flow Doppler ultrasound studies of the eye have been performed with systems that exceed US Food and Drug Administration permissible ophthalmic ultrasonic energy limits. The authors report a study of orbital vascular malformations using a novel, Food and Drug Administration compliant, ultrafast compound coherent plane-wave ultrasound device to produce power Doppler images.
Oscillopsia After Isolated Lateral Wall Decompression Versus Balanced or 3-Wall Decompression
Porr?a-Tub?o, Laura M.D., F.E.B.O.*,†; Sales-Sanz, Andrea M.D.‡,§; de-Arriba-Palomero, Pablo M.D.*,‡; Felix-Espinar, Beatriz M.D.*; de-Arriba-Palomero, Fernando M.D.*; Alonso-Formento, Nieves M.D.*; Albandea-Jiménez, Ana M.D.*; Rodr?guez-del-Valle, José Mar?a M.D.*; Sales-Sanz, Marco M.D., Ph.D., F.E.B.O
doi : 10.1097/IOP.0000000000001716
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 141-144
To assess the incidence of postoperative masticatory oscillopsia after orbital decompression, comparing results between isolated lateral wall and balanced or 3-wall orbital decompression.
Direct Injection of 5-Fluorouracil Improves Outcomes in Cicatrizing Conjunctival Disorders Secondary to Systemic Disease
Jovanovic, Nina M.D., M.Sc., M.P.H.*; Russell, William W. M.D.†; Heisel, Curtis J. M.D.†; Hood, Christopher T. M.D.†,‡; Kahana, Alon M.D., Ph.D
doi : 10.1097/IOP.0000000000001717
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 145-153
Conjunctival cicatrizing conditions are vision threatening, with poor outcomes despite aggressive systemic therapy. This study tests the utility of serial injections of 5-fluorouracil (5-FU) into the fornices to treat conjunctival scarring in patients with ocular cicatricial pemphigoid or Stevens–Johnson syndrome/toxic epidermal necrolysis.
Changes in Field of Binocular Single Vision and Ocular Deviation Angle After Balanced Orbital Decompression in Thyroid Eye Disease
Vaidya, Aric M.D.; Kakizaki, Hirohiko M.D., Ph.D.; Takahashi, Yasuhiro M.D., Ph.D.
doi : 10.1097/IOP.0000000000001712
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 154-160
To evaluate influential factors for changes in the binocular single vision (BSV) and ocular deviation angle in the medial direction after bilateral balanced orbital decompression in thyroid eye disease.
Inverted Papilloma of the Orbit and Nasolacrimal System
Wang, Jessie M.D.*; Ford, Joshua M.D.†; Esmaeli, Bita M.D.†; Langer, Paul M.D.‡; Esmaili, Neda M.D.§; Griepentrog, Gregory J. M.D.§; Couch, Steven M. M.D.?; Nguyen, John M.D.¶; Gold, Katherine G. M.D.#; Duerksen, Kathleen M.D.**; Burkat, Cat N. M.D.††; Hartstein, Morris E. M.D.‡‡; Gandhi, Parag M.D.§§; Sobel, Rachel K. M.D.??; Moon, Jee-Young Ph.D.¶¶; Barmettler, Anne M.D.*,##
doi : 10.1097/IOP.0000000000001719
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 161-167
Periocular inverted papilloma (IP) is a rare, locally aggressive tumor with a propensity for recurrence and malignant transformation. Historically treated via wide excision, this study examines the characteristics and management of periocular IP, comparing those confined to the nasolacrimal system with those invading the orbit.
Successful Free Bilamellar Eyelid Grafts for the Repair of Upper and Lower Eyelid Defects in Patients and Laser Speckle Contrast Imaging of Revascularization
Tenland, Kajsa M.D.*; Berggren, Johanna M.D.*; Engelsberg, Karl M.D., Ph.D.*; Bohman, Elin M.D.†; Dahlstrand, Ulf M.D., Ph.D.*; Castelo, Nazia M.D.*; Lindstedt, Sandra M.D., Ph.D.‡; Sheikh, Rafi M.D., Ph.D.*; Malmsj?, Malin M.D., Ph.D.*
doi : 10.1097/IOP.0000000000001724
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 168-172
It is generally believed that large eyelid defects must be repaired using a vascularized flap for 1 lamella, while the other can be a free graft. Recent studies indicate that the pedicle of a tarsoconjunctival flap does not contribute to blood perfusion. The purpose of this study was to explore whether large eyelid defects can be repaired using a free bilamellar eyelid autograft alone.
Pain Score Assessment Using Single-Dose IV Ketorolac Only, After External Dacryocystorhinostomy: A Randomized Double/Triple-Blind Placebo-Controlled Trial
Agarwal, Abhishek M.B.B.S., M.S.*; Patidar, Narendra M.B.B.S., D.O.M.S.†; Gabba, Harshdeep Singh M.B.B.S., M.S.‡; Sood, Devindra M.B.B.S., M.S.§; Piush, Parimal M.B.B.S., D.O.M.S.
doi : 10.1097/IOP.0000000000001730
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 173-175
To assess efficacy of intravenous (IV) ketorolac for postoperative pain control after external dacryocystorhinostomy.
Involvement of Multiple Trigeminal Nerve Branches in IgG4-Related Orbital Disease
Elkhamary, Sahar M. M.D.*,†; Cruz, Antonio Augusto V. M.D.‡; Zotin, Maria C. M.D.§; Cintra, Murilo M.D.§; Akaishi, Patricia M.D.‡; Galindo-Ferreiro, Alicia M.D.?; Alkatan, Hind M. M.D.¶; Chahud, Fernando M.D.
doi : 10.1097/IOP.0000000000001733
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 176-178
To describe the occurrence of multiple trigeminal nerves (TGNs) enlargement in patients with orbital IgG4-related disease.
Revisiting the Direct Brow Lift in Patients With Facial Palsy: 4 Key Modifications
Butler, Daniel P. M.B.B.S., M.B.A., F.R.C.S.; Nagendran, Sonali M.B., B.Ch., F.R.C.O.; Malhotra, Raman M.B., Ch.B., F.R.C.O.
doi : 10.1097/IOP.0000000000001794
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 179-182
The direct brow lift is a simple and popular technique, particularly in patients with brow ptosis secondary to facial palsy. It provides a high degree of control in determining the degree of brow elevation and shape achieved. However, it is arguably the least debated in terms of addressing some of its sequelae, namely the risks of a visible or indrawn scar and forehead paraesthesia. In this article, we report outcomes using four alternative principles to those outlined in current published literature.
Silicone Scaffold Support Using a Bilayer Dermal Regeneration Matrix Template for Correction of Primary or Recurrent Eyelid Retraction
Boulter, Tyler D. M.D.*; Burkat, Cat N. M.D., F.A.C.S.*; Downie, Elaine M.D.*; Hawes, Michael J. M.D.†; Willoughby, Brian M.D.†; Fante, Robert G. M.D., F.A.C.S.†
doi : 10.1097/IOP.0000000000001814
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 183-187
To evaluate the efficacy and safety of a bilayer dermal regenerative matrix for primary or complex/recurrent eyelid retraction.
Re: “Malignant Mixed Tumor (Carcinoma Ex Pleomorphic Adenoma) of the Lacrimal Gland”
Vahdani, Kaveh M.D., F.R.C.Ophth.; Rose, Geoffrey E. D.Sc., F.R.C.Ophth.
doi : 10.1097/IOP.0000000000001912
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 188
Reply re: “Malignant Mixed Tumor (Carcinoma Ex Pleomorphic Adenoma) of the Lacrimal Gland”
Esmaeli, Bita M.D., F.A.C.S.
doi : 10.1097/IOP.0000000000001913
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 188-189
Re: “In Vivo Morphology of Nasolacrimal Duct Opening Into the Inferior Meatus”
Lee, Patricia Ann L. M.D., M.B.A.; Kono, Shinjiro M.D.; Kakizaki, Hirohiko M.D., Ph.D.; Takahashi, Yasuhiro M.D., Ph.D
doi : 10.1097/IOP.0000000000001927
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 189
Reply re: “In Vivo Morphology of Nasolacrimal Duct Opening Into the Inferior Meatus”
Singh, Swati M.D.; Curragh, David M.D.; Davis, Gary M.D., F.R.A.N.Z.C.O.; Selva, Dinesh M.D., F.R.A.N.Z.C.O
doi : 10.1097/IOP.0000000000001926
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 189
Re: “Frontalis Suspension Using Autologous Fascia Lata in Children Under 3 Years Old”
Kashkouli, Mohsen Bahmani M.D.; Abdolalizadeh, Parya M.D., M.P.H
doi : 10.1097/IOP.0000000000001929
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 190
Reply re: “Frontalis Suspension Using Autologous Fascia Lata in Children Under 3 Years Old”
Sales-Sanz, Marco M.D., Ph.D.; Barrancos, Constanza M.D., Ph.D.; Garc?a-Cruz, Ignacio M.D.; Alonso-Formento, Nieves M.D.; Albandea, Ana Rosa M.D.; Losada-Bayo, Diego M.D., Ph.D.; Garc?a Ruiz, Oscar Andree M.D.
doi : 10.1097/IOP.0000000000001928
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 190
Re: “The Effect of Photographic Visual Aids in Preoperative Patient Counseling in Oculoplastic Surgery”
Schmuter, Gabriella B.S
doi : 10.1097/IOP.0000000000001934
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 190-191
Reply re: “The Effect of Photographic Visual Aids in Preoperative Patient Counseling in Oculoplastic Surgery”
Yom, Kelly H. B.A.; Shriver, Erin M. M.D., F.A.C.S.; Carter, Keith D. M.D., F.A.C.S.; Korn, Bobby S. M.D., Ph.D., F.A.C.S.; Kikkawa, Don O. M.D., F.A.C.S.; Ko, Audrey C. M.D.
doi : 10.1097/IOP.0000000000001935
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 191
Re: “‘Eyelid Parameter Changes in Patients With Marin-Amat Syndrome”
Khan, Muhammad A. B.Med.; Wong, Elizabeth L. S. B.Med.; Trang, Edward B.Med.; Huang, Jessica J. M. B.Med.; Jiang, Ivy W. B.Med.; Ting, Eugene M.D.; Crompton, John L. F.R.A.C.S., F.R.A.N.Z.C.O.; Agar, Ashish Ph.D., F.R.A.N.Z.C.O.; Francis, Ian C. Ph.D., F.R.A.C.S.
doi : 10.1097/IOP.0000000000001945
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 191-192
Reply re: “Eyelid Parameter Changes in Patients With Marin-Amat Syndrome”
Chao, Yu-Jang M.D.; Tsai, Chieh-Chih M.D., Ph.D
doi : 10.1097/IOP.0000000000001944
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 192-193
Aesthetic Abstracts
Burroughs, John M.D.*; Hwang, Catherine J. M.D.†; Nakra, Tanuj M.D.‡,§; Rootman, Daniel B. M.D.?; Wulc, Allan M.D., FACS¶; Woodward, Julie M.D.#
doi : 10.1097/IOP.0000000000001954
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 194-196
Oculoplastic Abstracts
Ali, Mohammad Javed M.D.*; Bernardini, Francesco M.D.†; Savar, Aaron M.D.‡; McNab, Alan M.D.§; Tawfik, Hatem A. M.D
doi : 10.1097/IOP.0000000000001955
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p 197-199
Acute Invasive Rhino-Orbital Mucormycosis in a Patient With COVID-19-Associated Acute Respiratory Distress Syndrome
Mekonnen, Zesemayat K. M.S.*; Ashraf, Davin C. M.D.†; Jankowski, Tyler D.O.‡; Grob, Seanna R. M.D.†; Vagefi, M. Reza M.D.†; Kersten, Robert C. M.D.†; Simko, Jeffry P. M.D., Ph.D.‡; Winn, Bryan J. M.D.
doi : 10.1097/IOP.0000000000001889
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e40-e80
Acute invasive fungal rhinosinusitis is a rare, although highly morbid, infection primarily affecting immunosuppressed individuals. The same population is at particularly high risk of complications and mortality in the setting of SARS-CoV-2 infection and coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome. The authors present a case of acute invasive fungal rhino-orbital mucormycosis in a patient with COVID-19 and discuss the prevalence, diagnosis, and treatment of fungal coinfections in COVID-19. Prompt recognition, initiation of therapy, and consideration of the challenges of rapidly evolving COVID-19 therapy guidelines are important for improving patient survival.
A Case of IgG4-Related Ophthalmic Disease With Coronary Arteritis
Suimon, Yuka M.D.*; Kase, Satoru Ph.D., M.D.*; Shimoyama, Shuhei M.D.†; Ishida, Susumu Ph.D., M.D.
doi : 10.1097/IOP.0000000000001731
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e43-e45
IgG4-related disease (IgG4-RD) is a fibro-inflammatory condition characterized by lymphoplasmacytic infiltrates rich in IgG4-positive plasma cells, often with elevated serum IgG4. Multiple organs may be affected. Coronary arteritis may be one form of fatal involvement in IgG4-RD. IgG4-RD can manifest as periocular lesions, called IgG4-related ophthalmic disease (IgG4-ROD). Here, the authors describe a patient with asymptomatic coronary arteritis detected after the diagnosis of IgG4-ROD. A 58-year-old male complained of eyelid swelling and diplopia without systemic symptoms. Swelling of bilateral lacrimal glands and infraorbital nerves, high serum IgG4 levels, and histopathology of lacrimal gland tissue fulfilled diagnostic criteria for IgG4-ROD. After diagnosis, systemic and coronary CT showed coronary lesions and coronary artery stenosis. After prednisolone at 40?mg/day was administered, swelling of the lacrimal glands, diplopia, and coronary lesions improved. This case emphasizes the importance of systemic screening, even if initial symptoms are solely associated with periocular regions.
Lacrimal Sac Actinomycosis: A Masquerade of Lacrimal Sac Malignancy
Singh, Manpreet M.S., D.N.B., F.A.I.C.O.*; Saikia, Uma Nahar M.D.†; Kaur, Manpreet M.S.*; Sharma, Manjula D.N.B., F.I.C.O.*; Gupta, Pankaj M.S.*
doi : 10.1097/IOP.0000000000001737
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e45-e47
A 60-year-old woman had blood-stained discharge with intermittent hemolacria from the left eye, of 3 months duration. The ophthalmic examination showed a firm, nontender, and immobile mass in the left lacrimal sac region. The sac regurgitation test was positive with purulent blood-stained discharge. Lacrimal punctum and canaliculi of both sides were normal. CT scan of orbits showed a hyperdense lesion in the left lacrimal sac region without bone erosion. A complete dacryocystectomy was performed, and the histopathology revealed actinomycosis of the lacrimal sac. At 14 months of follow-up visit, the patient has no clinical evidence of recurrence.
Henoch-Sch?nlein Purpura Associated With Diffuse Large B-cell Lymphoma of the Orbit
Bian, Yandong M.D.*; Oropesa, Susel M.D.*; Idowu, Oluwatobi O. M.D.†; Kudose, Satoru M.D.‡; Husain, Sameera M.D.§; Bhagat, Govind M.D.‡; Winn, Bryan J. MD*,†,?
doi : 10.1097/IOP.0000000000001739
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e47-e50
The association between Henoch-Sch?nlein purpura (HSP) and neoplasia is rare and has been more commonly reported in cases of solid tumors rather than hemotological malignancies. To the authors’ knowledge, HSP in association with orbital lymphoma has not been previously reported. An 84-year-old man underwent anterior orbitotomy with biopsy for a rapidly growing orbital mass. Immediately following this procedure, he developed petechial rash, flash pulmonary edema, and kidney dysfunction with hematuria and proteinuria. Orbital biopsy revealed diffuse large B-cell lymphoma while skin and kidney biopsies showed features consistent with HSP. Multidisciplinary team involvement and treatment with chemotherapy and corticosteroid resulted in an excellent clinical response. Clinicians should be aware that HSP and orbital diffuse large B-cell lymphoma can co-occur, potentially leading to life-threatening rapid fluid shifts and metabolic derangements.
A Case Series of Intramuscular Orbital Choristomatous Cysts
O’Rourke, Micheal M.B., F.R.C.S.I.(Ophth.), F.E.B.O., Ph.D.*; McKelvie, Penny M.B.B.S., F.R.C.P.A.†; McNab, Alan M.B.B.S., D.Med.Sc., F.R.A.N.Z.C.O., F.R.C.Ophth.*
doi : 10.1097/IOP.0000000000001742
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e51-e53
Intramuscular choristomatous cystic lesions within the orbit are rare but may require removal due to their volume effects. The authors describe 2 such cases of intramuscular cysts in adult patients. Both patients presented with symptoms due to local mass effects with swelling, proptosis and diplopia. Imaging confirmed cystic intramuscular masses. Surgical removal involved intraoperative decompression of the cyst to aid dissection with excision of some muscle fibers. Histology confirmed a keratinized stratified squamous lined dermoid cyst within lateral rectus for case 1 and stratified squamous non-keratinized conjunctival epithelium (simple primary conjunctival cyst) within inferior oblique for case 2.
Basal Cell Carcinoma and Eccrine Porocarcinoma of the Eyelid
Shoji, Marissa K. M.D.*; Tran, Ann Q. M.D.†; Lazzarini, Thomas A. M.D.*; Choi, Catherine J. M.D., M.S.‡; Tse, Brian C. M.D.*
doi : 10.1097/IOP.0000000000001743
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e53-e56
An 81-year-old woman presented with a progressively enlarging indurated, firm lesion encompassing one-third of the left upper eyelid. Four years prior, a similar lesion at that same site had been excised and diagnosed as a basal cell carcinoma. The patient underwent a full-thickness excision of the lesion with frozen section, cryotherapy, and reconstruction. A free tarsal graft and hard palate composite graft was used to reconstruct the posterior lamella. A Mustarde myocutaneous rotational flap was used to reconstruct the anterior lamella. Histopathology illustrated nests of pleomorphic basophilic cells with varying mitotic activity and immunohistochemical staining consistent with eccrine porocarcinoma. This case highlights similarities in the presentation and appearance of basal cell carcinoma and periorbital eccrine porocarcinoma. It is possible that there was de novo development of the 2 tumors on the eyelid or recurrence of a misdiagnosed eccrine porocarcinoma. Eccrine porocarcinomas are rare malignant sweat gland tumors associated with a risk of recurrence after excision and metastasis.
Orbital Cellulitis in Chagas Disease: An Unusual Presentation
Hernandez-Bogantes, Erick M.D.*,†; Campos-Fuentes, Erick M.D.‡; Barrantes-Dominguez, Mario M.D.*; Wu, Lihteh M.D.†,§
doi : 10.1097/IOP.0000000000001748
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e57-e59
Chagas disease is an inflammatory, infectious disease caused by the parasite Trypanosoma cruzi found in the feces of the triatomine bug, which can cause a sudden, brief acute illness, or it may become a long-lasting chronic condition. Chagas disease is common in South America and Central America, however, the constantly expanding global community has brought Chagas disease to the forefront of non-endemic areas, particularly the United States and Europe. The authors present a case of a 47-year-old healthy farmer diagnosed with a right orbital cellulitis refractory to systemic antibiotics. Based on clinical symptoms, the patient’s medical/demographical history and a proper differential diagnosis, an acute phase of Chagas disease was diagnosed. After antiparasitic treatment, the patient had a proper recovery and continued with a regular follow-up to monitor the possible development of a chronic phase.
Recurrence of a Totally Excised Cavernous Venous Malformation 25 Years Later
Kiratli, Hayyam M.D.*; Koç, Irem M.D.*; Toprak, Hilal M.D.*; Yildirim, Selma M.D.†; S?ylemezo?lu, Figen M.D.
doi : 10.1097/IOP.0000000000001751
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e59-e60
Recurrence of cavernous venous malformation is exceedingly rare. In 1995, a 16-year-old woman was referred for left axial proptosis. Her left visual acuity was 20/200, and there were choroidal folds in the OS. MRI studies showed a well-circumscribed retrobulbar intraconal mass in the left orbit. The tumor was totally removed with intact capsule through a transconjunctival orbitotomy and proved to be a cavernous venous malformation. In 2020, at the age of 41 years and 25 years after the operation, she again presented with left proptosis. Imaging results were very similar to those at first presentation. This tumor was also extirpated in its entirety via an inferior forniceal orbitotomy with the histopathologic diagnosis of a cavernous venous malformation. Her final left visual acuity remained 20/50. Women with orbital cavernous venous malformations, especially those who undergo surgical removal at a relatively young age are advised to have long-term follow up complemented with occasional imaging studies.
Nerve Sheath Myxoma Involving the Medial Rectus Muscle: A Case Report
Mora-Cantallops, Arnau M.D.*; Won-Kim, Hae-Ryung M.D.†,‡; Navarro-Cantero, Antonia M.D.§; Mart?nez-San-Mill?n, Juan M.D., Ph.D.?; Sales-Sanz, Marco M.D., Ph.D.*,
doi : 10.1097/IOP.0000000000001766
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e60-e62
A 63-year-old man reported a 2-year history of painless OS proptosis. The first MRI, performed in the institution of origin, resulted in a diagnosis of hemangioma versus orbital pseudotumor. Examination revealed proptosis and mild chemosis. Ancillary tests were normal, and oral prednisone was initiated without remarkable changes. Later, an incisional biopsy identified the lesion as an intramuscular myxoma of the left rectus, and a new MRI was ordered. It described a fusiform thickening of the medial rectus with and exophytic growth below the inferior rectus and upward toward the superior oblique. Due to the localization of the lesion, a combined transcaruncular and swinging eyelid approach with a lateral orbitotomy was performed. Histopathological examination revealed a proliferation of stromal origin composed of myxoid matrix with fusocellular and stellate-shaped cells. Cells were S-100, CD34, and CD56 positive and negative for epithelial membrane antigen, CD68, CD10, actin, and desmin. Results were consistent with a left medial rectus nerve sheath myxoma.
Role of Optic Nerve Sheath Fenestration in Inflammatory Pachymeningitis Causing Visual Impairment
Bae, Sol*; Dunn, Hamish*,†; Leahy, Kate‡; Tan, Kimberley‡; O’Donnell, Brett‡; Brazier, David§; Soh, Hwei-Choo?
doi : 10.1097/IOP.0000000000001769
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e63-e65
Eye disease due to pachymeningitis caused by immunoglobulin G4–related disease (IgG4-RD) is a rare occurrence. Here, the authors report a unique case of a patient presenting with visual loss from raised intracerebral pressure from pachymeningitis most likely related to IgG4-RD. The patient was treated with acetazolamide and steroids, and an optic nerve sheath fenestration was performed to successfully save the patients vision.
Uveal Melanoma Metastatic to the Cavernous Sinus: A Case Report
Assi, Lama H. M.D.*; Kheir, Wajiha J. M.D.*; Proia, Alan D. M.D., Ph.D.*,†; Materin, Miguel Angel M.D.*
doi : 10.1097/IOP.0000000000001778
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e66-e68
A woman in her early 50s previously treated 7 years prior with iodine-125 plaque brachytherapy without a biopsy for gene expression profiling for uveal melanoma in the left eye presented with a 3-week history of intermittent diplopia and headache. Ophthalmic examination was significant for limitation in left eye upward gaze; otherwise, examination revealed a stable, regressed tumor in the left eye, and normal vision, pressure, and pupils in both eyes. Neuroimaging showed a left cavernous sinus lesion, suggestive of a meningioma. Excisional biopsy revealed metastatic melanoma. The patient was treated with radiotherapy, and her diplopia resolved. Slight enlargement of the lesion was noted on neuroimaging 20 months later, and was treated with stereotactic radiosurgery. Serial neuroimaging in the following 6 months did not reveal any recurrences or new metastases. This case demonstrates the importance of investigating persistent diplopia in a patient with a history of uveal melanoma, and the possibility of metastases occurring in organs besides the liver or lung.
Ocular Syphilis Causing Panophthalmitis
Mathews, Basil M.D.; George, Roshan M.D.; Ulrich, Jan Niklas M.D
doi : 10.1097/IOP.0000000000001780
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e69-e71
Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum which is undergoing a global resurgence since its initial decline in the late 1980s. The authors present the case of a 30-year-old Caucasian female who was transferred to our institution for left-sided orbital cellulitis and ultimately diagnosed with ocular syphilis causing panophthalmitis. She was treated with intravenous penicillin and other broad-spectrum antibiotics, topical prednisolone, and cycloplegia, resulting in full recovery. Timely recognition of ocular syphilis by healthcare professionals is key in the prevention of visual sequelae from the infection.
Persistent Basal Cell Carcinoma Following Self-Treatment With a “Natural Cure,” Sanguinaria canadensis
Bozung, Alison K. O.D.*; Ko, Audrey C. M.D.†,‡; Gallo, Ryan A. B.A.*; Rong, Andrew J. M.D.*
doi : 10.1097/IOP.0000000000001784
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e71-e73
A 65-year-old woman presented with a 6-week history of redness, eyelid swelling, and discharge in the right eye. Slit lamp examination revealed right medial canthal erythema with cicatricial lower lid ectropion, retraction, and inferior punctal obliteration. The patient was previously diagnosed with a medial canthal basal cell carcinoma 1.5 years ago, but opted for self-treatment with black salve, a commonly used naturopathic “cure” for skin cancer. Each application resulted in increasingly severe periorbital inflammation with eventual eschar formation. Over time, this led to cicatricial band formation over the medial canthus. After biopsy confirmation of residual basal cell carcinoma within the cicatricial tissues, the patient underwent Mohs surgery followed by multistaged reconstruction. Herein, we report a case of patient whose use of an unproven naturopathic “cure” led to persistent periorbital inflammation, persistence of malignancy, and significant tissue destruction.
Intraocular Migration of Porous Polyethylene Malar Implant Used for Treacher Collins Eyelid Reconstruction
Khalil, Ali A. M.D.; Yassine, Salma M.D.; Torbey, Julien S. M.D.; Mehanna, Carl Joe M.D.; Alameddine, Ramzi M. M.D
doi : 10.1097/IOP.0000000000001786
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e73-e75
Lower eyelid colobomas associated with Treacher Collins syndrome can be challenging to repair because of associated orbital and midfacial dysostosis. Alloplastic implants such as porous polyethylene have been advocated as readily available malar implants to help improve eyelid retraction. The authors report the first case of porous polyethylene implant insidious migration into the orbit with subsequent scleral penetration. A 14-year-old male with Treacher Collins syndrome, presented with a 3-week history of left eye pain, redness, and eyelid swelling unresponsive to topical treatment. He previously had bilateral lower lid coloboma repair with alloplastic implant placement and full-thickness skin grafts. On exam, he had left eye injection and chemosis, with left hypotropia and complete restrictive ophthalmoplegia. Imaging revealed displacement of implant into the orbit with adherence and impingement on the eye globe.
Chocolate Cysts Associated With Porous Polyethylene Orbital Implants
Suller, Armida L. M.D.*; Parikh, Rupin N. M.D.†; Zhao, Jiawei M.D.†; Mahoney, Nicholas R. M.D.†; Campbell, Ashley A. M.D.†; Siadati, Sepideh M.D.†; Eberhart, Charles G. M.D., Ph.D.†; Fu, Roxana M
doi : 10.1097/IOP.0000000000001797
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e75-e80
Late-onset orbital hemorrhage is a rare complication of alloplastic implant use in orbital wall reconstruction following trauma. The authors report 3 patients with chocolate cysts presenting 3 to 9 years after orbital fracture repair with porous polyethylene implants. All patients were managed by implant removal and evacuation of cyst contents. Complete excision of the cyst was performed in 1 patient, while partial excision of the capsule was performed in 2 patients. Improvement of symptoms associated with the mass effects of the cyst was noted after surgical intervention. The authors also report the first case of orbital volume expansion from a chocolate cyst associated with a nonbarriered porous polyethylene implant. Delayed hemorrhage with capsule formation, although extremely rare, is a possible complication following orbital fracture repair with porous polyethylene implants.
Late Implant Hemorrhage Masquerading as an Orbital Mass
Chamberlain, Paul D. M.D.; Sweeney, Adam R. M.D.; Shetlar, Debra J. M.D.; Yen, Michael T. M.D
doi : 10.1097/IOP.0000000000001667
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e81
Bilobed Dermoid Cyst in Unique Location
Artymowicz, Anna M.D.*; Homer, Natalie M.D.†; Bratton, Emily M.D., F.A.C.S.†
doi : 10.1097/IOP.0000000000001668
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e82
Secretory Ductules of the Lacrimal Gland
Singh, Swati M.B.B.S., M.S.; Basu, Sayan M.B.B.S., M.S.
doi : 10.1097/IOP.0000000000001687
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e83
CT-Dacryocystography Findings in a Case of Atonic Lacrimal Sac
Bothra, Nandini M.D.; Ali, Mohammad Javed F.R.C.S., Ph.D.
doi : 10.1097/IOP.0000000000001701
Ophthalmic Plastic and Reconstructive Surgery: March/April 2021 - Volume 37 - Issue 2 - p e84
