1: Ophthal Plast Reconstr Surg. 2012 Jan;28(1):e27-9. 

Syringocystadenocarcinoma papilliferum of the eyelid.

Hoguet AS, Dolphin K, McCormick SA, Milman T.

Departments of *Ophthalmology and daggerPathology and Laboratory Medicine, The
New York Eye and Ear Infirmary, New York; and double daggerNew York Medical
College, Valhalla, New York, U.S.A.

An 86-year-old man presented with an ulcerated, painless right lower eyelid
lesion of unknown duration. Excisional biopsy was performed to rule out
suspected basal cell carcinoma. Pathologic evaluation demonstrated
syringocystadenocarcinoma papilliferum. Three months after complete excision of
the tumor, the patient remains well with no evidence of local recurrence or
metastases. Review of the literature identified 20 cases of
syringocystadenocarcinoma papilliferum, none of which presented in the skin of
the ocular adnexa. The authors review the typical presentation, clinical course,
and outcome of patients with syringocystadenocarcinoma papilliferum and compare
these data to the case presented here.

PMID: 22266788  [PubMed - in process]

2: Ophthal Plast Reconstr Surg. 2012 Jan;28(1):79-83. 

Idiopathic sclerosing orbital inflammation:  a review of demographics, clinical
presentation, imaging, pathology, treatment, and outcome.

Pemberton JD, Fay A.

*Department of Ophthalmology, Harvard Medical School; and daggerOphthalmic
Plastic and Reconstructive Surgery, Massachusetts Eye and Ear Infirmary, Boston,
Massachusetts, U.S.A.

PURPOSE: : To characterize clinical features, diagnostics studies, treatments,
and outcomes of patients with histologically proven idiopathic sclerosing
orbital inflammation (ISOI), to define optimal management for this recalcitrant
disease, and to determine changes in characterization and management by
comparing our results with the last significant literature review. METHODS: : A
search of the U.S. National Library of Medicine: National Institutes of Health's
electronic database for cases and case series in the English literature of
biopsy-proven ISOI published between March 1994 and September 2010 was
conducted. A cross-literature review was performed to tabulate demographics,
clinical findings, studies, treatments, and outcomes, which were compared with
the ISOI data published by Rootman et al. (1994). RESULTS: : Sixty-one cases, 71
eyes from 17 published reports, met inclusion criteria. No ethnic, sex, or
comorbidity predilection was established. Patients typically presented in the
fourth decade with proptosis (73%), pain (49%), and normal vision (44%). Orbital
imaging and histopathology were sparsely reported. Most common treatments
involved systemic corticosteroids either alone (34%) or combined with other
modalities (51%). CONCLUSIONS: : Characteristics of the disease remain
unchanged, and best management was not determined due to inconsistent reporting
methods across the literature. Collaboration with established groups (i.e.,
European Group On Graves Orbitopathy (EUGOGO), International Thyroid Eye Disease
Society (ITEDS)) or the formation of a new group of physicians and scientists to
help develop a systematic approach for future reporting and evaluation was
proposed.

PMID: 22262301  [PubMed - in process]

3: Ophthal Plast Reconstr Surg. 2012 Jan;28(1):77-8. 

Reply re:  "Trichoblastic Fibroma of the Eyelid".

Wladis EJ, Carlson JA, Linos K.

PMID: 22262300  [PubMed - in process]

4: Ophthal Plast Reconstr Surg. 2012 Jan;28(1):77. 

Re:  "trichoblastic fibroma of the eyelid".

Mencia-Gutierrez E, Gutierrez-Diaz E, Ricoy JR, Rodriguez-Peralto JL.

PMID: 22262299  [PubMed - in process]

5: Ophthal Plast Reconstr Surg. 2012 Jan;28(1):76-7. 

Reply re:  "Consecutive Conjunctivodacryocystorhinostomy Instrumentation".

Putterman AM.

PMID: 22262298  [PubMed - in process]

6: Ophthal Plast Reconstr Surg. 2012 Jan;28(1):76-7. 

Re:  "consecutive conjunctivodacryocystorhinostomy instrumentation".

McNab A.

PMID: 22262297  [PubMed - in process]

7: Ophthal Plast Reconstr Surg. 2012 Jan;28(1):75-6. 

Reply re:  "Human Immunodeficiency Virus-Associated Blepharoptosis".

Moscato EE, Seiff SR.

PMID: 22262296  [PubMed - in process]

8: Ophthal Plast Reconstr Surg. 2012 Jan;28(1):75. 

Re:  "human immunodeficiency virus-associated blepharoptosis".

Wiwanitkit V.

PMID: 22262295  [PubMed - in process]

9: Ophthal Plast Reconstr Surg. 2012 Jan;28(1):74-5. 

Osteoma cutis (nevus of nanta) of the eyebrow.

Abessi B, Meyer DR, Carlson JA.

PMID: 22262294  [PubMed - in process]

10: Ophthal Plast Reconstr Surg. 2012 Jan;28(1):74. 

Re:  "complications of two scleral flaps evisceration technique:  analysis of
201 procedures".

Kamal S, Kumar S.

PMID: 22262293  [PubMed - in process]

11: Ophthal Plast Reconstr Surg. 2012 Jan;28(1):69-72. 

CT Dimensions of the Lacrimal Gland in Graves Orbitopathy.

Harris MA, Realini T, Hogg JP, Sivak-Callcott JA.

*Utah Oculoplastic Consultants, P.C., Salt Lake City, Utah; daggerWest Virginia
University Eye Institute; and double daggerDepartment of Radiology, West
Virginia University, Morgantown, West Virginia, U.S.A.

PURPOSE: : To determine if lacrimal dimensions are enlarged in Graves
orbitopathy on CT and to correlate size with clinical data. METHODS: : One
hundred and twenty-eight adult Caucasian patients with Graves orbitopathy who
had CT at initial presentation to the authors' clinic were identified. The
lacrimal gland width and length were measured on axial and coronal scans using
the OsiriX software according to an established protocol. Comparison of
dimensions with a published normal population was made. Clinical data near the
time of CT were collected, including gender, age, smoking, subjective diplopia,
exophthalmometry, intraocular pressure, corneal staining, and the VISA activity
score for correlation with gland size. RESULTS: : The lacrimal glands in Graves
orbitopathy were significantly larger in all measured dimensions (p = 0.0001 for
each dimension). There were no differences between the genders (p values ranged
between 0.3855 and 0.8699). Exophthalmometry showed weak correlation with gland
size in all dimensions (p value range, 0.0058 to <0.0001; r value range, -0.2616
to 0.4181). Smoking correlated significantly with gland enlargement in right
coronal and axial width dimensions (p = 0.0150 and p = 0.0232, respectively).
VISA inflammatory score was borderline correlated with right axial width.
Lacrimal gland size did not correlate with diplopia, intraocular pressure, or
corneal staining. CONCLUSIONS: : The lacrimal gland is statistically
significantly enlarged in Graves orbitopathy. Only weak correlation was found
between gland enlargement and smoking, proptosis, and inflammatory activity.
Future research will address the causal changes of enlargement and their effect
on lacrimal function.

PMID: 22262292  [PubMed - in process]

12: Ophthal Plast Reconstr Surg. 2012 Jan;28(1):63-5. 

Punctum-sparing canaliculotomy for the treatment of canaliculitis.

Khu J, Mancini R.

Department of Ophthalmology, University of Texas Southwestern Medical Center,
Dallas, Texas, U.S.A.

PURPOSE: : Canaliculitis is an uncommon condition presenting with epiphora,
medial eyelid swelling, pouting punctum, and punctal discharge. Surgical
treatment with canaliculotomy with incision of the punctum is the treatment of
choice when medical management fails. The risk of epiphora and functioning of
the healed canaliculus is unknown. We describe a modification to the standard
technique by leaving the punctum intact, incising the canaliculus along its full
extent, and intubating the upper system with a silicone monocanalicular stent.
METHODS: : The lower punctum is dilated, and a Bowman probe inserted into the
canaliculus. A no. 11 Bard-Parker blade is used to incise the canaliculus along
its full extent, beginning 2 mm medial to the punctum, leaving the punctum
intact. The contents of the canaliculus are curetted, and purulent material,
drained. The wound is left open, and a mini-Monoka silicone monocanalicular
stent (FCI Ophthalmics, Marshfield Hills, MA) is inserted to bridge the gap
between the intact punctum and lacrimal sac. The incision is left to heal by
secondary intention. RESULTS: : This modified punctum-sparing canaliculotomy was
performed on 3 patients. In one patient, the upper and lower canaliculi were
treated. The other 2 patients had involvement of the lower canaliculus only. All
3 patients tolerated the procedure well with full resolution of symptoms. No
complaints of postoperative epiphora were made, and the system was patent to
irrigation postoperatively. CONCLUSIONS: : Punctum-sparing canaliculotomy with
monocanalicular intubation is an effective treatment for canaliculitis and may
be particularly useful in cases in which both upper and lower canaliculi are
involved and the risk of postoperative epiphora and canalicular scarring is
unknown.

PMID: 22262291  [PubMed - in process]

13: Ophthal Plast Reconstr Surg. 2012 Jan;28(1):54-6. 

Normal exophthalmometry measurements in a United States pediatric population.

Dijkstal JM, Bothun ED, Harrison AR, Lee MS.

Departments of *Ophthalmology, daggerPediatrics, double daggerOtolaryngology, 
section signNeurosurgery, and  ||Neurology, University of Minnesota,
Minneapolis, Minnesota, U.S.A.

PURPOSE: : The normal distribution of exophthalmometry measurements in a U.S.
pediatric population was determined as a reference for clinical practice.
METHODS: : This was a cross-sectional study, in which 673 normal subjects,
between 1 and 17 years of age, randomly selected from patients presenting to our
institution, were measured with an exophthalmometer. Normal volunteers also
participated at a booth at the annual state fair. Subjects were excluded for a
prior history of orbital tumor, craniofacial anomaly, thyroid disease, orbital
trauma, or inability to tolerate the measurement. RESULTS: : A total of 673
subjects (52% female) with a mean age of 9.6 years were studied. There was no
difference in exophthalmometric measurements between male and female subjects.
Mean exophthalmometric measurements increased with age: less than 4 years old
(13.2 mm), 5-8 years old (14.4 mm), 9-12 years old (15.2 mm), and 13-17 years
old (16.2 mm). Asymmetric measurements occurred in 100 (14.9%) subjects, with a
2-mm maximal difference in 2 subjects. CONCLUSION: : Exophthalmometric
measurements vary with age among the pediatric population. Reference data are
presented for each age group in a U.S. cohort.

PMID: 22262290  [PubMed - in process]

14: Ophthal Plast Reconstr Surg. 2012 Jan;28(1):40-3. 

Inferior orbital septum release compared with lateral canthotomy and cantholysis
in the management of orbital compartment syndrome.

Oester AE Jr, Fowler BT, Fleming JC.

*Vanderbilt University Medical Center, Nashville; and daggerHamilton Eye
Institute, University of Tennessee Health Science Center, Memphis, Tennessee,
U.S.A.

PURPOSE: : The purpose of this study is to assess the utility of inferior
orbital septum release compared with lateral canthotomy and inferior cantholysis
for the treatment of orbital compartment syndrome. METHOD: : An experimental
study design using a cadaver model for orbital compartment syndrome was used to
compare the efficacy of inferior orbital septum release with lateral canthotomy
and inferior cantholysis. Elevated orbital compartment pressures were created in
a total of 10 orbits of 5 fresh cadaver heads. Compartment pressure and
intraocular pressure were measured before and after inferior orbital septum
release and lateral canthotomy/cantholysis. Additionally, orbital compartment
pressure was compared with intraocular pressure at various pressures to assess
correlation. Statistical analysis was performed on the collected data for
efficacy comparison of the 2 procedures. RESULTS: : Both procedures were found
significantly to reduce orbital compartment pressure. Lateral canthotomy and
cantholysis was found to lower the pressure by an average of 56 mm Hg as
compared with inferior septal release, which resulted in an average of 52-mm Hg
reduction. Performing lateral canthotomy and cantholysis first, followed by
inferior septal release, resulted in a total pressure reduction of 73 mm Hg,
whereas reversing the order resulted in a reduction of 77 mm Hg. Both the first
and second steps, regardless of the order of procedure, were found to result in
a significant pressure reduction (p = 0.009 and 0.004, respectively). Comparison
of a series of data points collected during the induction of the experimental
compartment syndrome revealed a statistically significant correlation between
orbital compartment pressure and intraocular pressure (Spearman correlation of
0.978 and p value <0.001). DISCUSSION: : The study demonstrates that both
lateral canthotomy/cantholysis and inferior orbital septum release are equally
effective at reducing orbital compartment pressure. Additionally, the data
support an additive, synergistic reduction in compartment pressure when the
procedures are performed consecutively. The correlation of orbital compartment
pressure to intraocular pressure proves that intraocular pressure can be used as
a reliable measurement of orbital pressure during acute changes in orbital mass.
The results of this study demonstrate that the use of inferior orbital septum
release in conjunction with lateral canthotomy and cantholysis is superior to
the gold standard of isolated lateral canthotomy and cantholysis. We hope that
the implementation of orbital septum release will result in superior visual
outcomes.

PMID: 22262289  [PubMed - in process]

15: Ophthal Plast Reconstr Surg. 2012 Jan;28(1):35-9. 

Silicone intubation for the treatment of epiphora in adults with presumed
functional nasolacrimal duct obstruction.

Moscato EE, Dolmetsch AM, Silkiss RZ, Seiff SR.

*University of California, San Francisco, Department of Ophthalmology;
daggerCalifornia Pacific Medical Center, Department of Ophthalmology, San
Francisco, California, U.S.A.; double daggerUniversidad del Valle, Cali,
Division of Orbital, Ophthalmic and Reconstructive Surgery, Clinica de
Oftalmologia de Cali, Columbia.

PURPOSE: : To evaluate the long-term efficacy of silicone intubation in adults
with presumed functional nasolacrimal duct obstruction. METHODS: : This
retrospective cohort study reviewed adults with unilateral or bilateral epiphora
and presumed functional nasolacrimal duct obstruction treated with silicone
intubation and followed for signs of treatment failure (defined as persistent
epiphora or need for a secondary procedure). Median time to event (failure)
after silicone intubation was calculated using Kaplan-Meier survival analysis.
Analysis was conducted at the level of the individual eye, with clustering by
person taken in account. Cox proportional hazards models were used and adjusted
for within-subject variance using a robust sandwich estimator. RESULTS: :
Forty-four eyes from 30 patients with isolated functional nasolacrimal duct
obstruction underwent silicone intubation for epiphora. Mean time to stent
removal in 40 of 44 eyes was 4.0 (+/-4.1) months. Mean duration from the time of
stent placement to last follow-up was 2.6 (+/-2.0) years. Overall success after
silicone intubation for resolution of symptoms was 77%. Kaplan-Meier survival
analysis for time to event after silicone intubation yielded a median time of
5.7 years. Extrapolated data demonstrated a 96% success rate at 2 years and 85%
success rate at 3 years and predicted approximately 50% of patients to have
relief of epiphora between 5 and 6 years after silicone intubation. CONCLUSIONS:
: In this study, silicone intubation has good long-term success for relief of
epiphora in patients with presumed functional nasolacrimal duct obstruction.
This study provides important clinical information to guide management of
epiphora in adults with functional nasolacrimal duct obstruction.

PMID: 22262288  [PubMed - in process]

16: Ophthal Plast Reconstr Surg. 2012 Jan;28(1):30-4. 

Sentinel lymph node biopsy in patients with conjunctival and eyelid cancers: 
experience in 17 patients.

Maalouf TJ, Dolivet G, Angioi KS, Leroux A, Genin P, George JL.

*Department of Oculoplastic Surgery, Ophtalmologie B, CHU Nancy-Brabois; dagger
Department of Head and Neck Surgery, Centre Alexis Vautrin; and double
daggerDepartment of Histopathology, Centre Alexis Vautrin, Nancy, France.

PURPOSE: : To assess lymph node invasion through the use of sentinel lymph node
biopsy (SLNB) in conjunctival and eyelid tumor patients and ascertain the impact
of this technique in therapeutic management recommended by the multidisciplinary
consensus committee. METHODS: : A single center prospective nonrandomized
clinical study was conducted between January 2008 and January 2010. Seventeen
patients were included: 4 (2 conjunctiva and 2 eyelid) melanomas, 4 eyelid
Merkel cell tumors, 8 (2 conjunctiva, 2 eyelid, 2 eyelid and conjunctiva, 2
cornea and conjunctiva) squamous cell tumors, and 1 eyelid meibomian carcinoma.
Preoperative lymphoscintigraphy was done the day before surgery to label lymph
node(s). The surgical biopsy was then performed along with an extemporaneous
pathological examination followed by secondary complete lymph node dissection
only in instances of positive histology. RESULTS: : In all cases, one or more
sentinel lymph nodes were identified (3-13). Two biopsies (1 Merkel cell
carcinoma and 1 squamous cell carcinoma) revealed neoplastic invasion and led to
complete cervical node dissection. Adjunct regional treatment was indicated for
1 melanoma, for 4 Merkel cell tumors, and for 2 squamous cell carcinomas. One
false negative result was noted in the group of squamous cell carcinomas after 6
months, and it was treated. No relapse or death was observed for the other 16
patients. The mean overall follow-up was 18.2 months. CONCLUSION: : As in
previous studies, we found that SLNB for eyelid and conjunctival tumors is safe
and effective in identifying microscopically positive SLNs. This procedure may
also revive interest in the study of cervicofacial lymphatic drainage. Our
current investigation is to be expanded and extended to other medical teams.

PMID: 22262287  [PubMed - in process]