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Hirohiko Kakizaki - One of the best experts on this subject based on the ideXlab platform.
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Involvement of inward upper Eyelid push on the lower Eyelid during Eyelid closure in development of involutional lower Eyelid entropion.
European Journal of Ophthalmology, 2016Co-Authors: Tomomi Iuchi, Hyera Kang, Yasuhiro Takahashi, Shinichi Asamura, Noritaka Isogai, Hirohiko KakizakiAbstract:PURPOSE: To examine whether an inward upper Eyelid push on the lower Eyelid margin during Eyelid closure is involved in involutional lower Eyelid entropion. METHODS: This prospective observational study included 34 sides from 27 patients with involutional lower Eyelid entropion. The positional relationship between the upper and the affected lower Eyelid margins during Eyelid closure were examined before and after posterior layer advancement of the lower Eyelid retractors. In addition, we preoperatively examined whether the affected lower Eyelid turned in during a voluntary maximum force Eyelid closure from the normal position. We then held the upper Eyelid away from the lower Eyelid during a voluntary maximum force Eyelid closure to eliminate the influence of an inward upper Eyelid push on the lower Eyelid margin. At the time, we investigated whether the affected lower Eyelid turned in. All these examinations were performed from the normal lower Eyelid position. RESULTS: Although the upper Eyelid margin was on the lower Eyelid margin before surgery, this was corrected after surgery in all patients. All affected lower Eyelids turned in after voluntary maximum force Eyelid closure. However, the lower Eyelid margin did not show an inward rotation with holding of the upper Eyelid away from the lower Eyelid. CONCLUSIONS: These results indicate that an inward upper Eyelid push on the lower Eyelid is involved in development of an involutional lower Eyelid entropion.
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the levator aponeurosis contains smooth muscle fibers new findings in caucasians
Ophthalmic Plastic and Reconstructive Surgery, 2009Co-Authors: Hirohiko Kakizaki, Raman Malhotra, Simon N Madge, Dinesh SelvaAbstract:PURPOSE: To examine the microscopic structure of the upper Eyelid of Caucasians, in particular looking for evidence of the presence of smooth muscle fibers and the microscopic nature of the levator aponeurosis. METHODS: Full-thickness sagittal sections of central upper Eyelids from 11 postmortem upper Eyelids of 7 Caucasians (age range 78-101 years at death; mean age 87.7 years) were examined. The samples were stained with Masson trichrome and were microscopically examined for the presence of smooth muscle fibers and to determine whether the levator aponeurosis comprised one or more layers. RESULTS: All of the samples contained smooth muscle fibers, which were located posteriorly. Evidence of a clear double-layer structure was found in only 1 sample; the other 10 samples demonstrated a single monolayer, which was not reflected to the orbital septum but continued distally. CONCLUSIONS: In this series of upper Eyelid specimens of Caucasians, all aponeuroses contained smooth muscle fibers, the distribution of which was more concentrated posteriorly, identical to previous findings in Asian Eyelids and suggestive of a possible common mechanism of Eyelid tension regulation between races. Most of the levator aponeuroses examined had evidence of a single monolayer only; this represents a further absolute difference in the microanatomical structure of the upper Eyelids between Caucasians and Asians.
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overriding of the preseptal orbicularis oculi muscle in caucasian cadavers
Clinical Ophthalmology, 2009Co-Authors: Hirohiko Kakizaki, Weng Onn Chan, Yasuhiro Takahashi, Dinesh SelvaAbstract:We aimed to microscopically examine whether Caucasian Eyelids demonstrate overriding of preseptal orbicularis oculi muscle (OOM) over the pretarsal OOM in both lower and upper Eyelids. Full thickness sections of 13 lower Eyelids and 11 upper Eyelids from seven Caucasian cadavers were examined. In the lower Eyelids, all 13 specimens demonstrated clear overriding of preseptal OOM over the pretarsal OOM. The overriding part extended almost to the level of lower Eyelid margin. However, in the upper Eyelids, only one of the 11 Eyelids demonstrated overriding, and the overriding part only extended to the level of mid-tarsal plate. Our result strongly supports the hypothesis of overriding of the preseptal OOM over the pretarsal OOM as an etiology of involutional lower Eyelid entropion. The relatively low frequency of upper Eyelid overriding preseptal OOM in our study reflects and may explain the rare occurrence of involutional upper Eyelid entropion.
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Modified marginal myotomy for thyroid-related upper Eyelid retraction
European Journal of Plastic Surgery, 2008Co-Authors: Hirohiko KakizakiAbstract:The purpose of this study is to report a modified marginal myotomy procedure for thyroid-related upper Eyelid retraction using techniques of quantification and contour adjustment for blepharoptosis surgery, of which surgeons have more experience than of upper Eyelid retraction surgery. Eleven upper Eyelids of ten patients, average age 41.6 years, were operated on. All patients were clinically and biochemically euthyroid at operation without having had progression of Eyelid and orbital changes for at least 6 months prior to surgery. Margin reflex distances of upper Eyelids (MRD-1; normal, 2.0–5.5 mm) were measured preoperatively and 3 months postoperatively. Upper Eyelid contours were also examined before and after surgery. Medial and lateral horns and the distal attachment of levator aponeurosis were incised to produce a levator flap, which was transversely incised in two positions. The edge of the incised levator was fixed on the appropriate part of the tarsus. MRD-1 values were considerably decreased in all cases, ranging from 2.5 to 6.0 mm (average, 3.8 mm). All final MRD-1 results ranged from 2.5 to 5.0 mm (average, 3.4 mm) and the laterality of MRD-1 was within 1 mm higher or lower than the contralateral Eyelids, although a patient with bilateral retraction who had only unilateral operation did not show a symmetrical Eyelid height to the contralateral one. All Eyelids but one showed acceptable upper Eyelid contours; the inconsistent Eyelid temporally showed nasal flare, but finally acquired a good curvature. Our procedure effectively decreased upper Eyelid height with good contour by utilising techniques from blepharoptosis surgery.
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reverse ptosis repair targeting the posterior layer of the lower Eyelid retractor
Ophthalmic Plastic and Reconstructive Surgery, 2007Co-Authors: Hirohiko Kakizaki, Masahiro Zako, Masayoshi IwakiAbstract:PURPOSE To present a new technique for reverse ptosis repair targeting the posterior layer of the lower Eyelid retractor. METHODS Retrospective case series. RESULTS The posterior layer of the lower Eyelid retractor was advanced to improve reverse ptosis in 2 cases, which resulted from either microphthalmos or seventh nerve palsy. The affected lower Eyelid levels were adjusted to almost the same height as the contralateral lower Eyelids. One year after surgery, both cases maintained the same Eyelid levels as were seen immediately postoperatively. CONCLUSIONS Posterior layer advancement of the lower Eyelid retractor is effective and useful for reverse ptosis repair.
Dinesh Selva - One of the best experts on this subject based on the ideXlab platform.
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the levator aponeurosis contains smooth muscle fibers new findings in caucasians
Ophthalmic Plastic and Reconstructive Surgery, 2009Co-Authors: Hirohiko Kakizaki, Raman Malhotra, Simon N Madge, Dinesh SelvaAbstract:PURPOSE: To examine the microscopic structure of the upper Eyelid of Caucasians, in particular looking for evidence of the presence of smooth muscle fibers and the microscopic nature of the levator aponeurosis. METHODS: Full-thickness sagittal sections of central upper Eyelids from 11 postmortem upper Eyelids of 7 Caucasians (age range 78-101 years at death; mean age 87.7 years) were examined. The samples were stained with Masson trichrome and were microscopically examined for the presence of smooth muscle fibers and to determine whether the levator aponeurosis comprised one or more layers. RESULTS: All of the samples contained smooth muscle fibers, which were located posteriorly. Evidence of a clear double-layer structure was found in only 1 sample; the other 10 samples demonstrated a single monolayer, which was not reflected to the orbital septum but continued distally. CONCLUSIONS: In this series of upper Eyelid specimens of Caucasians, all aponeuroses contained smooth muscle fibers, the distribution of which was more concentrated posteriorly, identical to previous findings in Asian Eyelids and suggestive of a possible common mechanism of Eyelid tension regulation between races. Most of the levator aponeuroses examined had evidence of a single monolayer only; this represents a further absolute difference in the microanatomical structure of the upper Eyelids between Caucasians and Asians.
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overriding of the preseptal orbicularis oculi muscle in caucasian cadavers
Clinical Ophthalmology, 2009Co-Authors: Hirohiko Kakizaki, Weng Onn Chan, Yasuhiro Takahashi, Dinesh SelvaAbstract:We aimed to microscopically examine whether Caucasian Eyelids demonstrate overriding of preseptal orbicularis oculi muscle (OOM) over the pretarsal OOM in both lower and upper Eyelids. Full thickness sections of 13 lower Eyelids and 11 upper Eyelids from seven Caucasian cadavers were examined. In the lower Eyelids, all 13 specimens demonstrated clear overriding of preseptal OOM over the pretarsal OOM. The overriding part extended almost to the level of lower Eyelid margin. However, in the upper Eyelids, only one of the 11 Eyelids demonstrated overriding, and the overriding part only extended to the level of mid-tarsal plate. Our result strongly supports the hypothesis of overriding of the preseptal OOM over the pretarsal OOM as an etiology of involutional lower Eyelid entropion. The relatively low frequency of upper Eyelid overriding preseptal OOM in our study reflects and may explain the rare occurrence of involutional upper Eyelid entropion.
Morris E Hartstein - One of the best experts on this subject based on the ideXlab platform.
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conservative management of necrotizing fasciitis of the Eyelids
Ophthalmology, 2002Co-Authors: Jason A Luksich, John B Holds, Morris E HartsteinAbstract:Abstract Objective To describe the management of patients with necrotizing fasciitis of the Eyelids. Design Retrospective, noncomparative interventional case series. Participants Seven patients with necrotizing fasciitis limited to the Eyelids. Methods Retrospective review of the charts and photographs of seven patients with necrotizing fasciitis limited to the Eyelids. Main outcome measures Eyelid function and appearance, mortality, and morbidity. Results Seven of seven patients had good Eyelid function and adequate appearance without reconstruction after healing. No deaths occurred. Conclusions Eyelid necrosis due to necrotizing fasciitis can be a devastating condition. The morbidity and mortality of selected cases are reduced with prompt and appropriate antimicrobial therapy and nonaggressive debridement of necrotic tissue after autodemarcation of the necrotic zone.
Mariana Mata-plathy - One of the best experts on this subject based on the ideXlab platform.
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Eyelids Necrotizing Fasciitis in Children
Journal of Clinical & Experimental Ophthalmology, 2012Co-Authors: Rafael Corredor-osorio, Alejandra Ocando-cedeño, Mariana Mata-plathyAbstract:Purpose: Two cases of Eyelids Necrotizing Fasciitis in children were presented. The first one with chicken pox, and the second was previously healthy. Design: Interventional Report cases. Methods: Two cases of Eyelids Necrotizing Fasciitis in children were studied. The first case was a 7 years old girl who presented a necrotizing fasciitis in superior and inferior Eyelids with a serious toxic shock as a complication of the chicken pox. Parenteral antibiotic treatment was not enough to stop the necrotizing process and surgical debriding was needed for the gangrenous tissues. In the Eyelid culture Streptococcus pyogenes grew. A free skin graft was implanted to the inferior Eyelid. The second case was presented in a 6 months old girl, who developed necrotizing fasciitis of her lower left Eyelid without any trauma antecedent. The ocular and blood cultures did not show any microorganism growth. An appropriate antibiotic coverage and management of systemic manifestations leads to a fast recovering; even though the developed necrosis demanded surgical debriding and a retroauricular free skin graft was performed later.
John W Shore - One of the best experts on this subject based on the ideXlab platform.
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results of mullerotomy and levator aponeurosis transposition for the correction of upper Eyelid retraction in graves disease
Ophthalmology, 1995Co-Authors: Emily J Ceisler, Jurij R Bilyk, Peter A D Rubin, William R Burks, John W ShoreAbstract:Background: Upper Eyelid retraction in Graves disease may cause functional morbidity and aesthetic deformity. Surgery to correct thyroid-related upper Eyelid retraction may result in temporal undercorrection with failure to eliminate lateral Eyelid retraction, leading in turn to a poor Eyelid contour postoperatively. Methods: In 1984, one of the authors developed a new procedure for correcting moderate to severe upper Eyelid retraction associated with Graves disease. The surgical technique consists of a Mullerotomy and recession of the levator aponeurosis combined with medial transposition of the lateral horn of the levator aponeurosis. The procedure was performed on 37 patients (72 Eyelids). Muller's muscle was used as the spacer to set the Eyelid height. Transposition of the levator aponeurosis allowed adjustment of Eyelid contour. Results: Thirty patients (58 Eyelids) had excellent results, six (13 Eyelids) had good results, and one (1 Eyelid) had a poor result: No patient required re-operation for asymmetry, unacceptable contour, or malposition. Only one Eyelid had significant overcorrection, and only one Eyelid had significant undercorrection, requiring further surgery. The most frequent unwanted effects were high Eyelid crease (24 Eyelids) and residual temporal flare (6 Eyelids); however, most of these were seen early in the series before the lateral levator transposition modification was added. Conclusion: This procedure allows successful and simultaneous correction of both Eyelid position and contour in patients with moderate to severe thyroid-related upper Eyelid retraction.
