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Orbital and Ocular Adnexal Manifestations of Adult T-Cell Leukemia/Lymphoma: a Case Report and Systematic Review
Henry, Roger K.; Bagg, Adam; Wu, Connie; Eagle, Ralph C. Jr.; Milman, Tatyana Less
doi : 10.1097/IOP.0000000000001695
Ophthalmic Plastic and Reconstructive Surgery. 37(3):201-211, May/June 2021.
To describe a patient with orbital adult T-cell leukemia/lymphoma (ATLL) and to review the literature on presentation, diagnostics, management, and clinical course of this rare disease.
Simultaneous Orbital and Intracranial Abscesses in 17 Cases
Park, Michael M.; Ahmed, Osama M.; Ng, John D.; Vloka, Caroline N.; Dansdill, Daniel; Shinder, Roman; Sniegowski, Matthew; Richani, Karina; Lucarelli, Mark J.; van Landingham, Suzanne W.; Pointdujour-Lim, Renelle Less
doi : 10.1097/IOP.0000000000001760
Ophthalmic Plastic and Reconstructive Surgery. 37(3):212-216, May/June 2021.
To describe the demographics, clinical presentation, treatment, and outcomes of a rare cohort with simultaneous orbital and intracranial abscesses.
Carcinoid Tumors of the Orbit and Ocular Adnexa
Mustak, Hamzah; Liu, Wenjing; Murta, Fabiola; Ozgur, Omar; Couch, Steven; Garrity, James; Shinder, Roman; Kazim, Michael; Callahan, Alison; Hayek, Brent; Kim, HeeJoon; Yu, Fei; Esmaeli, Bita; Rose, Geoffrey; Rootman, Daniel Less
doi : 10.1097/IOP.0000000000001715
Ophthalmic Plastic and Reconstructive Surgery. 37(3):217-225, May/June 2021.
Well-differentiated neuroendocrine or carcinoid tumors are found most commonly in the gastrointestinal tract. When metastatic to the orbit, they tend to have a propensity for the extraocular muscles. The purpose of this study was to better understand the diversity in presentation of orbital carcinoid disease and to determine predictors for survival.
The Presentation and Surgical Treatment of Peribulbar Dermolipomas
Vahdani, Kaveh; Rose, Geoffrey E.
doi : 10.1097/IOP.0000000000001848
Ophthalmic Plastic and Reconstructive Surgery. 37(3):226-229, May/June 2021.
To evaluate the presentation, treatment, and outcome for patients with peribulbar dermolipomas and describe a reliable technique for excision of large lesions.
Supraorbital Neuralgia Associated With Thyroid Eye Disease
Patrinely, J. Randall Jr; Hamilton, Kristy L.; Parke, Robert B.; Patrinely, James R.; Soparkar, Charles N. S. Less
doi : 10.1097/IOP.0000000000001762
Ophthalmic Plastic and Reconstructive Surgery. 37(3):230-235, May/June 2021.
To identify the relationship between thyroid eye disease (TED) and supraorbital neuralgia (SON) and establish a reliable approach to the diagnosis and management of TED-associated SON.
Progress Towards Parity: Female Representation in the American Society of Ophthalmic Plastic and Reconstructive Surgery
Azad, Amee D.; Rosenblatt, Tatiana R.; Chandramohan, Arthika; Fountain, Tamara R.; Kossler, Andrea L. Less
doi : 10.1097/IOP.0000000000001764
Ophthalmic Plastic and Reconstructive Surgery. 37(3):236-240, May/June 2021.
To report female representation within the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) at all levels of career achievement over 50 years.
Patient-Specific Implants in Oculofacial Plastic Surgery
Copperman, Thomas S; Idowu, Oluwatobi O.; Jalaj, Sanjai; Winn, Bryan J.; Pham, Chau; Setabutr, Pete; Kersten, Robert C.; Vagefi, M. Reza Less
doi : 10.1097/IOP.0000000000001765
Ophthalmic Plastic and Reconstructive Surgery. 37(3):241-247, May/June 2021.
To investigate how patient-specific implants (PSIs) are being utilized for periocular facial skeletal reconstruction. Specifically, to characterize indications for custom implants, areas of reconstruction, intraoperative variables impacting implant placement, as well as to report on postoperative outcomes.
Risks and Benefits of Surgical Excision of Orbital Cavernous Venous Malformations (So-Called Cavernous Hemangioma): Factors Influencing the Outcome
Strianese, Diego; Bonavolontà, Giulio; Iuliano, Adriana; Mariniello, Giuseppe; Elefante, Andrea; Liuzzi, Raffaele Less
doi : 10.1097/IOP.0000000000001767
Ophthalmic Plastic and Reconstructive Surgery. 37(3):248-254, May/June 2021.
To assess risks and benefits associated with surgical excision of orbital cavernous venous malformation and analyze factors influencing the outcome.
Tarsal Epithelial Cysts: Prevalence, Case Series, and Synthesis of Existing Literature
Ahmad, Meleha; Chen, Hung-Chang; Chang, Jessica R.; Hodgson, Nickisa; McDonnell, Emma C.; Henderson, Amanda D.; Siadati, Sepideh; Eberhart, Charles G.; McCulley, Timothy J. Less
doi : 10.1097/IOP.0000000000001795
Ophthalmic Plastic and Reconstructive Surgery. 37(3):255-261, May/June 2021.
Tarsal epithelial cysts (TECs) are squamous epithelial-lined lesions of the eyelid that are often mistaken for chalazia or epidermal inclusion cysts. They remain poorly described in the literature. This study is designed to characterize the prevalence and clinical features of TEC.
Prognostic Factors for Orbital Exenteration, Local Recurrence, Metastasis, and Death From Disease in Conjunctival Squamous Cell Carcinoma
El-Hadad, Christian; Rubin, Maria Laura; Nagarajan, Priya; Ford, Joshua Richard; Xu, Shiqiong Jr; Ning, Jing; Esmaeli, Bita Less
doi : 10.1097/IOP.0000000000001798
Ophthalmic Plastic and Reconstructive Surgery. 37(3):262-268, May/June 2021.
Information regarding risk of metastasis and disease-related death (DD) from conjunctival squamous cell carcinoma (SCC) is relatively scarce. We explored prognostic factors for orbital exenteration, local recurrence, nodal metastasis, and DD in patients with conjunctival SCC.
Revascularization After H-plasty Reconstructive Surgery in the Periorbital Region Monitored With Laser Speckle Contrast Imaging
Berggren, Johanna; Castelo, Nazia; Tenland, Kajsa; Engelsberg, Karl; Dahlstand, Ulf; Albinsson, John; Sheikh, Rafi; Lindstedt, Sandra; Malmsj?, Malin Less
doi : 10.1097/IOP.0000000000001799
Ophthalmic Plastic and Reconstructive Surgery. 37(3):269-273, May/June 2021.
H-plasty reconstructive surgery is commonly used to close defects after tumor excision in the periorbital region. Revascularization of the bipedicle skin flaps is essential for healing. However, it has not previously been possible to study this revascularization in humans due to the lack of noninvasive perfusion monitoring techniques. The aim was to monitor perfusion in H-plasty flaps during surgery and during postoperative follow-up, using laser speckle contrast imaging.
Histopathologic Observations of Eyes in Exenterated Orbits After Neoadjuvant Intra-Arterial Cytoreductive Chemotherapy for Adenoid Cystic Carcinoma of the Lacrimal Gland
Liao, Sophie D.; Erickson, Benjamin P.; Kapila, Neha; Dubovy, Sander R.; Tse, David T. Less
doi : 10.1097/IOP.0000000000001808
Ophthalmic Plastic and Reconstructive Surgery. 37(3):274-279, May/June 2021.
To assess whether exenteration specimens obtained after neoadjuvant intra-arterial cytoreductive chemotherapy (IACC) for adenoid cystic carcinoma of the lacrimal gland demonstrate significant ocular histopathologic alterations that might preclude future pursuit of globe-preserving therapy.
Intravenous Catheter Employed in Peritrochlear Injection of Triamcinolone in the Treatment of Trochleitis
Rubenstein, Jordan A.; Chang, Chih-Chiun; Idowu, Oluwatobi O.; Winn, Bryan J. Less
doi : 10.1097/IOP.0000000000001826
Ophthalmic Plastic and Reconstructive Surgery. 37(3):280-283, May/June 2021.
Injection of corticosteroid into the peritrochlear region is a widely practiced and highly successful treatment option for trochleitis, conventionally using a 25- or 27-gauge needle for the steroid injection. Injection into the vascular-rich peritrochlear region poses a risk, albeit rare, of central retinal artery occlusion or orbital hemorrhage. We describe a potentially safer method of delivering triamcinolone to the peritrochlear region using a 24-gauge intravenous catheter.
Orbital Bony Reconstruction With Presized and Precontoured Porous Polyethylene–Titanium Implants
Blessing, Nathan W.; Rong, Andrew J.; Tse, Brian C.; Erickson, Benjamin P.; Lee, Bradford W.; Johnson, Thomas E. Less
doi : 10.1097/IOP.0000000000001829
Ophthalmic Plastic and Reconstructive Surgery. 37(3):284-289, May/June 2021.
Complex bony orbital defects are reconstructively challenging due to loss of intraoperative anatomical landmarks and adjacent support. Presized and precontoured porous polyethylene–titanium implants (Medpor Titan 3D Orbital Floor Implant) are designed to reestablish normal orbital floor and medial wall anatomy and are modeled after anatomically averaged orbits. This is the first study to report clinical outcomes with this implant.
What is in a Name? It is Time to Retire the Term “Asian Blepharoplasty”
Lorden, Diana S.; Kim, Angela; Tejawinata, Felicia; Samimi, David B.; Lo, Christopher C.; Dresner, Steven C.; Burnstine, Michael A. Less
doi : 10.1097/IOP.0000000000001903
Ophthalmic Plastic and Reconstructive Surgery. 37(3):290-293, May/June 2021.
This perspective explores the term “Asian blepharoplasty” and its socioemotional meaning to some patients.
Commentary on Burnstine MA, “What’s in a Name? It is Time to Retire the Term 'Asian Blepharoplasty'”
Liu, Don
doi : 10.1097/IOP.0000000000001930
Ophthalmic Plastic and Reconstructive Surgery. 37(3):294-295, May/June 2021.
Re: “Stereotactic Navigation Improves Outcomes of Orbital Decompression Surgery for Thyroid Associated Orbitopathy”
Cohen, Adam J.
doi : 10.1097/IOP.0000000000001951
Ophthalmic Plastic and Reconstructive Surgery. 37(3):296, May/June 2021.
Reply re: “Stereotactic Navigation Improves Outcomes of Orbital Decompression Surgery for Thyroid Associated Orbitopathy”
Kahana, Alon; Heisel, Curtis J.
doi : 10.1097/IOP.0000000000001952
Ophthalmic Plastic and Reconstructive Surgery. 37(3):296, May/June 2021.
Re: “Change in Lower Eyelid Contour Following Ectropion Repair With Lateral Tarsal Strip”
Cruz, Antonio A. V.; Garcia, Dennis M.
doi : 10.1097/IOP.0000000000001965
Ophthalmic Plastic and Reconstructive Surgery. 37(3):296-297, May/June 2021.
Reply re: “Change in Lower Eyelid Contour Following Ectropion Repair With Lateral Tarsal Strip”
Mancini, Ronald
doi : 10.1097/IOP.0000000000001966
Ophthalmic Plastic and Reconstructive Surgery. 37(3):297, May/June 2021.
Re: “Diagnosis and Management of Acute Thrombosis in Venous Dominant Orbital Venolymphatic Malformations”
McNab, Alan A.; Hardy, Thomas G.
doi : 10.1097/IOP.0000000000001967
Ophthalmic Plastic and Reconstructive Surgery. 37(3):297, May/June 2021.
Reply re: “Diagnosis and Management of Acute Thrombosis in Venous Dominant Orbital Venolymphatic Malformations”
Grob, Seanna R.; Bokman, Christine; Nathe, Connor; Feldman, Kenneth A.; Rootman, Daniel B. Less
doi : 10.1097/IOP.0000000000001968
Ophthalmic Plastic and Reconstructive Surgery. 37(3):298-299, May/June 2021.
Aesthetic Abstracts
Burroughs, John; Hwang, Catherine J.; Rootman, Daniel B.; Nakra, Tanuj; Woodward, Julie; Wulc, Allan Less
doi : 10.1097/IOP.0000000000001973
Ophthalmic Plastic and Reconstructive Surgery. 37(3):300-302, May/June 2021.
Oculoplastic Abstracts
Ali, Mohammad Javed; Bernardini, Francesco P.; Savar, Aaron; McNab, Alan A.; Tawfik, Hatem A. Less
doi : 10.1097/IOP.0000000000001977
Ophthalmic Plastic and Reconstructive Surgery. 37(3):303-304, May/June 2021.
Ocular Perfusion Following Orbital Apex Exenteration
Gallo, Ryan A.; Pirakitikulr, Nathan; Tse, David T.; Rong, Andrew J. Less
doi : 10.1097/IOP.0000000000001838
Ophthalmic Plastic and Reconstructive Surgery. 37(3):e85-e88, May/June 2021.
A 68-year-old man with a history of type 2 diabetes mellitus and kidney transplantation on chronic immunosuppression presented with right-sided proptosis and vision loss. He was hospitalized 4 months prior for invasive sinus aspergillosis. MRI revealed abnormal enhancement in the right orbital apex, inferior medial right orbit, anterior cranial fossa floor, and anterior aspect of the falx cerebri. The patient was successfully managed with extensive sinus surgery, bifrontal craniotomy with resection of dura, cribriform plate resection, and a right orbital apex exenteration. The globe and anterior orbital structures were preserved to cover the large surgical sinodural-orbital defect and avoid complex reconstructive surgery. Orbital perfusion was maintained by exploiting the robust anastomoses between branches of external carotid and ophthalmic artery.
Orbital Crystal-Storing Histiocytosis: A Clinicopathologic Study of 4 Cases
Wilde, Caroline; Amin, Sepideh; Poitelea, Cornelia; Uddin, Jimmy; Rose, Geoffrey E.; Sherafat, Hooman Less
doi : 10.1097/IOP.0000000000001841
Ophthalmic Plastic and Reconstructive Surgery. 37(3):e89-e91, May/June 2021.
The authors report the clinicopathological features of crystal-storing histiocytosis (CSH) that involved the orbit and conjunctiva and review published cases of CSH. Cases of histologically proven CSH were identified from archives at the Institute of Ophthalmology, London, and a retrospective review of clinical details and pathology was performed for cases between 1997 and 2017. Four cases of CSH were identified: 1 might have arisen from an inflammatory reaction to a silicone retinal buckle and 3 others occurred with localized B-cell lymphomas. Two patients presented with a conjunctival mass, and 2 had an orbital mass causing proptosis and hypoglobus. One case was associated with amyloid deposition and another had an earlier diagnosis of IgG4-related disease. In the patient without underlying lymphoma, the condition settled with removal of the explant and orbital mass, and the 3 with lymphoma underwent orbital radiotherapy with cessation of disease progression. All patients retained good vision. Ocular CSH is rare, can present in several ways, and should prompt investigation for an underlying lymphoproliferative disorder.
Rituximab Therapy for Recalcitrant Idiopathic Sclerosing Orbital Inflammation
Yazici, Bulent; Cekic, Sukru; Yalcinkaya, Ulviye; Kilic, S. Sebnem Less
doi : 10.1097/IOP.0000000000001843
Ophthalmic Plastic and Reconstructive Surgery. 37(3):e91-e97, May/June 2021.
Three patients (3 female patients; aged 7, 35, and 61 years) who had recalcitrant idiopathic sclerosing orbital inflammation were treated with rituximab. The disease was bilateral in 1 patient (4 orbits in total): diffuse in 2 and localized in 2 orbits. It caused optic neuropathy in 1 orbit of each patient. Conventional immunotherapy and tumor debulking surgery were unsuccessful in controlling the disease. After rituximab infusions (375?mg/m 2 /week for 4 weeks), all patients improved symptomatically. Radiologically, the local lesions resolved completely and diffuse lesions partially. Two patients with recurrent inflammation during follow up (78, 58, and 51 months) responded well to immediate, short-term steroid treatments. Short-term rituximab therapy can induce effective remissions in patients with refractory idiopathic sclerosing orbital inflammation. Early and local lesions may respond better to treatment than diffuse lesions. Nevertheless, inflammatory exacerbations can occur during late follow up.
Orbital Compartment Syndrome After High-speed Air-Gasoline Blast Injury
Zhao, Zhenyang; Malik, Amina; Bhat, Nita; Bindiganavile, Shruthi Harish; Pandit, Rahul T.; Kavoussi, Shaheen C.; Lee, Andrew G. Less
doi : 10.1097/IOP.0000000000001845
Ophthalmic Plastic and Reconstructive Surgery. 37(3):e97-e100, May/June 2021.
Orbital compartment syndrome is an ophthalmologic emergency that requires timely surgical intervention. The authors present a rare case of orbital compartment syndrome in a 30-year-old male injured by forceful entry of air-gasoline mixture into the orbit, secondary to inadvertent firing of the piston from running mechanical diagnostics on an automobile internal combustion engine. Orbital CT revealed extensive orbital emphysema with both pre- and postseptal involvement and diffuse chemical cellulitis. Serial exams revealed rapid deterioration of vision with elevated intraocular pressure and development of eyelid, corneal, and orbital edema; a relative afferent pupillary defect and optic nerve hypoperfusion. He was started on intravenous steroids and underwent an emergent lateral canthotomy with cantholysis, which temporarily reduced the intraocular pressure. However, a second rapid increase in soft tissue swelling resulted in another episode of ocular hypertension and compressive optic neuropathy, requiring emergent orbital bony decompression, which was followed by decreased intraocular and orbital pressure. The patient later developed progressive corneal opacification indicating delayed chemical injury. This was managed with a 10-day course of aggressive topical and systemic antiinflammatory agents with significant improvement in visual acuity. At last follow up, the vision was 20/30 and the corneal and eyelid edema had cleared.
Unilateral Ptosis, Proptosis, and Orbital Myositis After Shingles Vaccination
Chon, Brian H.; Hwang, Catherine J.; Perry, Julian D.
doi : 10.1097/IOP.0000000000001847
Ophthalmic Plastic and Reconstructive Surgery. 37(3):e100-e103, May/June 2021.
Vaccinations for shingles are recommended for most adults over 60 years of age and are typically well tolerated. The present case describes acute onset of unilateral ptosis, proptosis, and orbital myositis developing within days after administration of shingles vaccination. The episode resolved to baseline after 1 week of treatment with steroids. To the authors' knowledge, this is first reported case of orbital inflammation following shingles vaccination. Given the temporal relationship and rapid response to treatment, this may represent an autoimmune reaction to the shingles vaccine.
Bilateral Nodular Episcleritis: A Rare Presentation of Relapsing Polychondritis
Meel, Rachna; Das, Deepsekhar; Bhadu, Danveer; Sen, Seema; Kishor, Kriti; Pushker, Neelam Less
doi : 10.1097/IOP.0000000000001849
Ophthalmic Plastic and Reconstructive Surgery. 37(3):e103-e105, May/June 2021.
Herein, the authors report a case of relapsing polychondritis (RP) presenting as isolated bilateral nodular episcleritis. A 23-year-old male presented to us with bilateral large ocular surface masses for which he had received antitubercular medications. A workup was performed to rule out infective, neoplastic, and immune etiologies, after which the patient was then treated empirically with systemic steroids. No response to steroids was noted, so the lesions were removed surgically. On follow up, he developed redness of both ears sparing the lobules. A biopsy from ear lesions supported the diagnosis of RP. At a follow up of 2 years, the patient is free of any ocular or systemic manifestation. To the best of the authors' knowledge, this is the first reported case of RP presenting with bilateral giant nodular episcleritis and treated successfully with surgery. A multidisciplinary approach is essential for the management of such cases. A long-term close follow up is vital for early detection of associated malignancies like multiple myeloma.
Posteriorly Displaced Orbital Implant Causing Intractable Anophthalmic Socket Pain
Hartford, Juliet B.; Zehden, Jason; Sweeney, Adam R.; Yen, Michael T. Less
doi : 10.1097/IOP.0000000000001859
Ophthalmic Plastic and Reconstructive Surgery. 37(3):e105-e107, May/June 2021.
Anophthalmic socket pain is a rare complication of enucleation. The authors present a patient presenting with intractable anophthalmic socket pain due to a posteriorly displaced orbital implant. The patient’s pain localized to the V1 and V2 orbitofacial dermatomes, and we suspect compression of the frontal and zygomatic branches of the ophthalmic and maxillary nerves, respectively, as the underlying etiology of the patient’s pain. Removal of the implant and placement of a dermis fat graft was effective at alleviating the patient’s symptoms.
Multicameral Steatocystoma Simplex of the Caruncle
Charles, Norman C.; Jakobiec, Frederick A.; Sherwood, Pamela; Belinsky, Irina Less
doi : 10.1097/IOP.0000000000001861
Ophthalmic Plastic and Reconstructive Surgery. 37(3):e107-e109, May/June 2021.
A yellow cyst of the caruncle in a 68-year-old man displayed the characteristic sebaceous glands and sebocytes of steatocystoma within the cyst wall, with a unique configuration of multiple branching compartments. The cyst lining was of trichilemmal character, lacking a keratohyalin granular layer, and replicated the immunohistochemical characteristics of a previously reported caruncular steatocystoma with the exception of a positive trichilemmal marker, calretinin, in the present case. Four previous cases of caruncular steatocystoma have been described, only one of which incorporated immunohistochemical analysis. Steatocystoma develops from a sebaceous gland duct, which displayed in this case multiple chambers subdividing what is usually a single round lumen.
Congenital Opticmeningoceles
Cruz, Antonio A. V.; Akaishi, Patricia M. S.; Bernardini, Francesco; Chahud, Fernando Less
doi : 10.1097/IOP.0000000000001864
Ophthalmic Plastic and Reconstructive Surgery. 37(3):e109-e111, May/June 2021.
Congenital optic nerve cystic-like malformations associated with normally developed globes are extremely rare. We describe 3 children who presented since birth with proptosis, and eye motility limitation. MRI showed in all cases that the intraorbital segment of the optic nerves was malformed with large cystic-like lesions in the intraconal segment of the orbit. In all cases, biopsies of the wall of the lesions were positive for glial fibrillary acidic protein. Since this protein is a neurobiomarker that exists only in astrocytes in the central nervous system, nonmyelinating Schwann cells of peripheral nerves, and enteric glial cells, we believe that these lesions represent true opticmeningoceles.
Primary Melanoma of the Lacrimal Sac Treated With Pembrolizumab
Salloum, George; Dryden, Stephen; Meador, Andrew G.; Kurochkin, Philip D.; Chamberlain, Benjamin K.; Fasig, John H.; Waynick, Christopher A.; Wesley, Ralph E.; Everman, Kelly R. Less
doi : 10.1097/IOP.0000000000001868
Ophthalmic Plastic and Reconstructive Surgery. 37(3):e111-e112, May/June 2021.
Primary melanoma of the lacrimal sac is a rare entity, with high mortality and a propensity for recurrence. This report details a patient with widely metastatic melanoma discovered after biopsy of abnormal lacrimal sac tissue during routine dacryocystorhinostomy. The patient subsequently underwent local excision and treatment with pembrolizumab. At the time of this writing, it has been 24 months since the original diagnosis with resolution of his lacrimal and orbital lesions and improvement in all metastatic lesions. This case highlights the growing use of cancer genomics and immunotherapeutic agents in orbital aspects of oncology and reinforces the role of a multidisciplinary approach in the treatment of such diseases.
Occult Rosacea Diagnosed After Recurring Blepharoplasty Incision Inflammation
Medsinge, Anagha; Googe, Paul; Fowler, Amy M
doi : 10.1097/IOP.0000000000001874
Ophthalmic Plastic and Reconstructive Surgery. 37(3):e112-e114, May/June 2021.
We report an unusual case of a 58-year-old Caucasian female who developed intermittent eyelid erythema, edema, and wound thickening in the early postoperative period after bilateral upper eyelid blepharoplasty. These flares of inflammation sometimes appeared to respond to systemic antibiotics and steroid preparations and sometimes not. Because of concerns for possible mycobacterial infection, biopsy of the upper eyelid incision was performed and histopathology confirmed rosacea. Symptoms resolved with oral azithromycin. Our patient did not have a diagnosis of rosacea preoperatively. We believe that rosacea should be kept in mind in cases with either prolonged inflammation or recurrent inflammation in previously quiet eyelid incisions.
IgG4-related Disease Presenting as Isolated Cicatrising Conjunctivitis
Cameron, Cassie A.; Juniat, Valerie; Mills, Richard A. D.; Hughes, Tiffany; Klebe, Sonja; Selva, Dinesh Less
doi : 10.1097/IOP.0000000000001881
Ophthalmic Plastic and Reconstructive Surgery. 37(3):e114-e117, May/June 2021.
A 46-year-old male presented with a 12-month history of trichiasis and was found to have significant, progressive cicatrization of the tarsal conjunctiva causing entropion of the upper and lower eyelids. A biopsy confirmed the diagnosis of IgG4-related cicatrizing conjunctivitis in the absence of any other organ involvement, a previously unreported manifestation of this immune-mediated disease.
Use of an Ultrasonic Aspirator in Removal of an Orbital Rim Hemangioma
Donegan, Patrick; Law, James; Schauwecker, Suzanne M.; Mawn, Louise A. Less
doi : 10.1097/IOP.0000000000001886
Ophthalmic Plastic and Reconstructive Surgery. 37(3):e117-e120, May/June 2021.
Intraosseous hemangiomas are rare bony neoplasms that infrequently develop in the calvarium or facial bones. Due to their highly vascular nature, biopsy or resection of these tumors can present a surgical challenge, with reports of significant blood loss during tumor resection. Traditional surgical resection of intraosseous hemangiomas often includes the use of high speed oscillating or sagittal saws. Ultrasonic aspirators, which spare adjacent soft-tissue structures and minimize blood loss, have been successfully used in resection of firm soft tissue masses of the orbit; however, this technology has not been demonstrated in the treatment of a vascular tumor in the orbit. The authors present the case of a 37-year-old woman who presented with an intraosseous hemangioma at the left inferior orbital rim and maxilla; the mass was successfully resected with the aid of a Sonopet Ultrasonic Aspirator bone knife. The knife allowed for simultaneous emulsification and cautery of the bone encasing the mass with low risk to sensitive surrounding tissue.
Malignant Conversion of Eyelid Capillary Hemangioma to Cutaneous Angiosarcoma
Heinze, Kevin; Pham, Chau; Lin, Amy; Setabutr, Pete Less
doi : 10.1097/IOP.0000000000001888
Ophthalmic Plastic and Reconstructive Surgery. 37(3):e120-e122, May/June 2021.
Angiosarcomas represent a rare aggressive malignancy of endothelial cell origin that carry a poor prognosis. Here, the authors report the case of a 71-year-old male presenting with a well-differentiated angiosarcoma of the right upper eyelid which arose at the site of a congenital eyelid hemangioma. The patient had undergone multiple surgical resections of the hemangioma previously without adjunctive radiation therapy. This lends evidence to the potential for malignant transformation of benign hemangiomas, and long-term monitoring of benign cutaneous vascular lesions should be considered.
Nonintestinal Type Adenocarcinoma of the Ethmoid Sinus With Unusual Cribriform Histologic Pattern
Tukel, Matthew R.; Adelman, Madeline J.; Gladstone, Geoffrey J.; Appleford, Colin Less
doi : 10.1097/IOP.0000000000001736
Ophthalmic Plastic and Reconstructive Surgery. 37(3):e123, May/June 2021.
Distinct Canalicular Openings Into the Lacrimal Sac Without a Common Canaliculus
Ali, Mohammad Javed
doi : 10.1097/IOP.0000000000001834
Ophthalmic Plastic and Reconstructive Surgery. 37(3):e124, May/June 2021.
Intravascular Papillary Endothelial Hyperplasia: A Rare Cause of Painful Proptosis
Vempuluru, Vijitha S.; Jakati, Saumya; Kaliki, Swathi
doi : 10.1097/IOP.0000000000001611
Ophthalmic Plastic and Reconstructive Surgery. 37(3):e125, May/June 2021.
