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Hirohiko Kakizaki - One of the best experts on this subject based on the ideXlab platform.
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Involutional Lower Eyelid entropion: causative factors and therapeutic management
International Ophthalmology, 2019Co-Authors: Yoshiyuki Kitaguchi, Yasuhiro Takahashi, Maria Suzanne Sabundayo, Jacqueline Mupas-uy, Hirohiko KakizakiAbstract:Purpose To summarize proposed causative factors and the outcomes of surgical practices for involutional Lower Eyelid entropion. Methods We reviewed the literature on proposed causative factors and the outcomes of surgical practices for involutional Lower Eyelid entropion, searched on PubMed. Results Vertical and horizontal laxities of the Lower Eyelid, and overriding of the preseptal orbicularis oculi muscle onto the pretarsal orbicularis oculi muscle have been proposed as the major causes of involutional Lower Eyelid entropion. Treatment procedures have been developed over the years to address one or more of these causative factors. Conclusions Various causative factors and treatment procedures have been advocated to explain and correct involutional Lower Eyelid entropion. The appropriate procedure is chosen according to the patient’s condition, such as the presence of vertical laxity, horizontal laxity, and orbicularis oculi muscle overriding. A combination of these procedures to correct multiple factors further decreases the recurrence rate.
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involutional Lower Eyelid entropion causative factors and therapeutic management
International Ophthalmology, 2019Co-Authors: Peihsuan Lin, Yasuhiro Takahashi, Yoshiyuki Kitaguchi, Jacqueline Mupasuy, Maria Suzanne Sabundayo, Hirohiko KakizakiAbstract:To summarize proposed causative factors and the outcomes of surgical practices for involutional Lower Eyelid entropion. We reviewed the literature on proposed causative factors and the outcomes of surgical practices for involutional Lower Eyelid entropion, searched on PubMed. Vertical and horizontal laxities of the Lower Eyelid, and overriding of the preseptal orbicularis oculi muscle onto the pretarsal orbicularis oculi muscle have been proposed as the major causes of involutional Lower Eyelid entropion. Treatment procedures have been developed over the years to address one or more of these causative factors. Various causative factors and treatment procedures have been advocated to explain and correct involutional Lower Eyelid entropion. The appropriate procedure is chosen according to the patient’s condition, such as the presence of vertical laxity, horizontal laxity, and orbicularis oculi muscle overriding. A combination of these procedures to correct multiple factors further decreases the recurrence rate.
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posterior layer advancement of Lower Eyelid retractors with transcanthal canthopexy for involutional Lower Eyelid entropion
Eye, 2016Co-Authors: Y Ishida, Yasuhiro Takahashi, Hirohiko KakizakiAbstract:PurposeThe purpose of this study was to examine the surgical outcome of posterior layer advancement of the Lower Eyelid retractors (LER) with transcanthal canthopexy for involutional Lower Eyelid entropion.Patients and methodsFifty-one Eyelids of 41 patients with involutional entropion and vertical and horizontal laxities that underwent posterior layer advancement of the LER with transcanthal canthopexy were retrospectively reviewed. As a control, we also reviewed previously reported data from 47 entropic Eyelids of 37 patients with vertical and horizontal laxities that were successfully corrected using LER advancement and a lateral tarsal strip procedure. Surgical success was defined as the normal Eyelid position without contact of any cilia to the globe at the last follow-up examination.ResultsAll Eyelids in the present study group were judged as successfully treated without recurrence after 13.9±9.2 months of follow up (mean±SD). The surgical time in the present study group (22.4±5.5 min) was significantly shorter than that in the control group (mean 31.3±4.9 min; P<0.001; Student's t-test). None of the patients showed lateral canthal deformity after surgery.ConclusionsPosterior layer advancement of the LER with transcanthal canthopexy provided complete surgical success with shorter surgical time without the risk of lateral canthal deformity. Posterior layer advancement of the LER with transcanthal canthopexy can be an option for correction of involutional Lower Eyelid entropion in patients with both vertical and horizontal laxities.
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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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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:PurposeTo examine whether an inward upper Eyelid push on the Lower Eyelid margin during Eyelid closure is involved in involutional Lower Eyelid entropion.MethodsThis prospective observational study...
Don O Kikkawa - One of the best experts on this subject based on the ideXlab platform.
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treatment of postblepharoplasty Lower Eyelid retraction with dermis fat spacer grafting
2015Co-Authors: Bobby S Korn, Don O KikkawaAbstract:Lower Eyelid retraction is a potential complication following transcutaneous Lower Eyelid blepharoplasty. Several techniques have been described to treat postblepharoplasty Eyelid retraction. We describe a new method of Lower Eyelid retraction using dermis fat as a posterior lamellar graft combined with midfacial lifting.
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treatment of Lower Eyelid malposition with dermis fat grafting
Ophthalmology, 2008Co-Authors: Bobby S Korn, Morris E Hartstein, Steven R. Cohen, Don O Kikkawa, Christine C AnnunziataAbstract:Purpose To report a new technique in the repair of Lower Eyelid malposition using dermis fat as a posterior lamellar spacer graft. Design Retrospective, consecutive, nonrandomized interventional case series. Participants Eleven patients who underwent surgical correction for symptomatic Lower Eyelid malposition using dermis fat as a spacer graft. Methods Patients with symptomatic Lower Eyelid malposition after blepharoplasty, trauma, craniofacial syndromes, and human immunodeficiency virus-associated lipodystrophy were treated with midfacial lifting combined with dermis fat posterior lamellar spacer grafting. Main Outcome Measures Preoperative and postoperative measurements of Eyelid position, margin-to-reflex distance (defined as the distance from the upper Eyelid to the central corneal light reflex and the distance from the Lower Eyelid to the corneal light reflex), lagophthalmos, corneal staining, presence of ocular surface symptoms, and patient satisfaction. Results All patients who underwent dermis fat spacer grafting during Lower Eyelid malposition repair noted improvement in ocular surface symptoms and restoration of normal Eyelid position. Conclusions Dermis fat is a novel posterior lamellar spacer graft and offers numerous advantages over conventional Lower Eyelid spacer grafts for repair of Lower Eyelid malposition.
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Lower-Eyelid blepharoplasty.
International ophthalmology clinics, 1997Co-Authors: Don O Kikkawa, Jonathan W. KimAbstract:In summary, the concept of one operation for all patients who present for Lower-Eyelid blepharoplasty should be abandoned. Surgical procedures should be tailored for each individual, depending on the sources of concern and the anatomical defects present. The vast majority of patients are served best by combining transconjunctival blepharoplasty with adjunctive procedures. Transcutaneous Lower-lid blepharoplasty has few indications. By combining and choosing the proper techniques, the aesthetics surgeon can achieve Lower-Eyelid rejuvenation while preserving function and minimizing complications.
Raman Malhotra - One of the best experts on this subject based on the ideXlab platform.
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Outcomes of Lower Eyelid retractor recession and lateral horn lysis in Lower Eyelid elevation for facial nerve palsy.
Eye (London England), 2017Co-Authors: P Tan, J Wong, W F Siah, Raman MalhotraAbstract:Outcomes of Lower Eyelid retractor recession and lateral horn lysis in Lower Eyelid elevation for facial nerve palsy
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a review of combined orbital decompression and Lower Eyelid recession surgery for Lower Eyelid retraction in thyroid orbitopathy
British Journal of Ophthalmology, 2011Co-Authors: Jonathan H Norris, Jonathan J Ross, Philip Oreilly, Raman MalhotraAbstract:Background/aims Eyelid retraction in thyroid orbitopathy is traditionally managed with staged surgery after orbital decompression. We review the benefit of concurrent inferior retractor recession at the time of orbital decompression when closing a swinging-Eyelid flap. Methods A retrospective, comparative, non-randomised clinical audit of 34 eyes of 22 patients with thyroid orbitopathy over a 3-year period was carried out. Patients were divided into a combined orbital decompression and inferior retractor recession (with lateral horn release) group (RG, n=13) and an orbital decompression non-recession group (NRG, n=21). Groups were matched for age, walls decompressed, volume of intraconal fat excised and improvement in exophthalmometry. Surgery involved one to three wall decompressions and intraconal fat excision via a swinging Eyelid and transcaruncular approach. We report outcomes at 6 months based on postoperative standard photographs. Lower Eyelid height, inferior scleral show and Lower Eyelid lateral flare were recorded by two blinded, independent assessors. Results The RG achieved a greater improvement in Lower Eyelid elevation (1.8±0.8 mm) compared to the NRG (1.1±0.8 mm) (p=0.042). The RG (58%) and NRG (40%) had improvement of Lower lid lateral flare. Mean scleral show improved in both the RG (1.3 mm) and NRG (0.9 mm). No Lower Eyelid complications occurred. Conclusion Combining orbital decompression with concurrent inferior retractor recession at the time of swinging-Eyelid flap closure is safe and improves Lower lid height postoperatively compared to decompression alone.
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Lower Eyelid retractors in Caucasians
Ophthalmology, 2009Co-Authors: Hirohiko Kakizaki, Raman Malhotra, Simon N Madge, Wengonn Chan, Dinesh SelvaAbstract:Purpose To examine the microscopic anatomic features of Lower Eyelid retractors in Caucasians, specifically looking for an anatomic division of the retractors into 2 layers, as is present in the Asian Eyelid. Design Experimental anatomic study. Participants Seven Caucasian cadavers (13 Lower Eyelids: 7 right and 6 left). Methods Sagittal full-thickness sections of the cadaveric Lower Eyelids were prepared and stained with Masson's trichrome. The specimens were examined microscopically to discern the configuration of the Lower Eyelid retractors. Micrographs were obtained with a digital camera system attached to the microscope. Main Outcome Measures Histologic findings of the Lower Eyelid retractors in Caucasians. Results Although 2 specimens were excluded because anatomic details were severely disrupted during slide preparation, all the other samples demonstrated clear double layers of the Lower Eyelid retractors. Conclusions The Lower Eyelid retractors in Caucasians consist of clear double layers. In this regard, no differences were detected between Caucasian and Asian Eyelid anatomic features. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Lower Eyelid anatomy: an update.
Annals of plastic surgery, 2009Co-Authors: Hirohiko Kakizaki, Raman Malhotra, Simon N Madge, Dinesh SelvaAbstract:The gross anatomy of the Lower Eyelid is analogous to that of the upper Eyelid, however, the Lower Eyelid has a more simplified structure with less dynamic movement. Common malpositions of the Lower Eyelid include entropion and ectropion, rehabilitative surgery of which requires a thorough understanding of Lower Eyelid anatomy. Furthermore, precise anatomic knowledge is a prerequisite for both reconstructive and cosmetic Lower Eyelid surgery in order for it to be performed appropriately. In this review, we present the clinical anatomy of the structures of the Lower Eyelid, as well as highlighting relevant surgical implications. Featured here are the structure of the different Eyelid lamellae, the Lower Eyelid retractors and their relations, the orbital septum, fat pad compartments, and Lockwood ligament.
Bobby S Korn - One of the best experts on this subject based on the ideXlab platform.
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treatment of postblepharoplasty Lower Eyelid retraction with dermis fat spacer grafting
2015Co-Authors: Bobby S Korn, Don O KikkawaAbstract:Lower Eyelid retraction is a potential complication following transcutaneous Lower Eyelid blepharoplasty. Several techniques have been described to treat postblepharoplasty Eyelid retraction. We describe a new method of Lower Eyelid retraction using dermis fat as a posterior lamellar graft combined with midfacial lifting.
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treatment of Lower Eyelid malposition with dermis fat grafting
Ophthalmology, 2008Co-Authors: Bobby S Korn, Morris E Hartstein, Steven R. Cohen, Don O Kikkawa, Christine C AnnunziataAbstract:Purpose To report a new technique in the repair of Lower Eyelid malposition using dermis fat as a posterior lamellar spacer graft. Design Retrospective, consecutive, nonrandomized interventional case series. Participants Eleven patients who underwent surgical correction for symptomatic Lower Eyelid malposition using dermis fat as a spacer graft. Methods Patients with symptomatic Lower Eyelid malposition after blepharoplasty, trauma, craniofacial syndromes, and human immunodeficiency virus-associated lipodystrophy were treated with midfacial lifting combined with dermis fat posterior lamellar spacer grafting. Main Outcome Measures Preoperative and postoperative measurements of Eyelid position, margin-to-reflex distance (defined as the distance from the upper Eyelid to the central corneal light reflex and the distance from the Lower Eyelid to the corneal light reflex), lagophthalmos, corneal staining, presence of ocular surface symptoms, and patient satisfaction. Results All patients who underwent dermis fat spacer grafting during Lower Eyelid malposition repair noted improvement in ocular surface symptoms and restoration of normal Eyelid position. Conclusions Dermis fat is a novel posterior lamellar spacer graft and offers numerous advantages over conventional Lower Eyelid spacer grafts for repair of Lower Eyelid malposition.
Yasuhiro Takahashi - One of the best experts on this subject based on the ideXlab platform.
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Involutional Lower Eyelid entropion: causative factors and therapeutic management
International Ophthalmology, 2019Co-Authors: Yoshiyuki Kitaguchi, Yasuhiro Takahashi, Maria Suzanne Sabundayo, Jacqueline Mupas-uy, Hirohiko KakizakiAbstract:Purpose To summarize proposed causative factors and the outcomes of surgical practices for involutional Lower Eyelid entropion. Methods We reviewed the literature on proposed causative factors and the outcomes of surgical practices for involutional Lower Eyelid entropion, searched on PubMed. Results Vertical and horizontal laxities of the Lower Eyelid, and overriding of the preseptal orbicularis oculi muscle onto the pretarsal orbicularis oculi muscle have been proposed as the major causes of involutional Lower Eyelid entropion. Treatment procedures have been developed over the years to address one or more of these causative factors. Conclusions Various causative factors and treatment procedures have been advocated to explain and correct involutional Lower Eyelid entropion. The appropriate procedure is chosen according to the patient’s condition, such as the presence of vertical laxity, horizontal laxity, and orbicularis oculi muscle overriding. A combination of these procedures to correct multiple factors further decreases the recurrence rate.
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involutional Lower Eyelid entropion causative factors and therapeutic management
International Ophthalmology, 2019Co-Authors: Peihsuan Lin, Yasuhiro Takahashi, Yoshiyuki Kitaguchi, Jacqueline Mupasuy, Maria Suzanne Sabundayo, Hirohiko KakizakiAbstract:To summarize proposed causative factors and the outcomes of surgical practices for involutional Lower Eyelid entropion. We reviewed the literature on proposed causative factors and the outcomes of surgical practices for involutional Lower Eyelid entropion, searched on PubMed. Vertical and horizontal laxities of the Lower Eyelid, and overriding of the preseptal orbicularis oculi muscle onto the pretarsal orbicularis oculi muscle have been proposed as the major causes of involutional Lower Eyelid entropion. Treatment procedures have been developed over the years to address one or more of these causative factors. Various causative factors and treatment procedures have been advocated to explain and correct involutional Lower Eyelid entropion. The appropriate procedure is chosen according to the patient’s condition, such as the presence of vertical laxity, horizontal laxity, and orbicularis oculi muscle overriding. A combination of these procedures to correct multiple factors further decreases the recurrence rate.
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posterior layer advancement of Lower Eyelid retractors with transcanthal canthopexy for involutional Lower Eyelid entropion
Eye, 2016Co-Authors: Y Ishida, Yasuhiro Takahashi, Hirohiko KakizakiAbstract:PurposeThe purpose of this study was to examine the surgical outcome of posterior layer advancement of the Lower Eyelid retractors (LER) with transcanthal canthopexy for involutional Lower Eyelid entropion.Patients and methodsFifty-one Eyelids of 41 patients with involutional entropion and vertical and horizontal laxities that underwent posterior layer advancement of the LER with transcanthal canthopexy were retrospectively reviewed. As a control, we also reviewed previously reported data from 47 entropic Eyelids of 37 patients with vertical and horizontal laxities that were successfully corrected using LER advancement and a lateral tarsal strip procedure. Surgical success was defined as the normal Eyelid position without contact of any cilia to the globe at the last follow-up examination.ResultsAll Eyelids in the present study group were judged as successfully treated without recurrence after 13.9±9.2 months of follow up (mean±SD). The surgical time in the present study group (22.4±5.5 min) was significantly shorter than that in the control group (mean 31.3±4.9 min; P<0.001; Student's t-test). None of the patients showed lateral canthal deformity after surgery.ConclusionsPosterior layer advancement of the LER with transcanthal canthopexy provided complete surgical success with shorter surgical time without the risk of lateral canthal deformity. Posterior layer advancement of the LER with transcanthal canthopexy can be an option for correction of involutional Lower Eyelid entropion in patients with both vertical and horizontal laxities.
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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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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:PurposeTo examine whether an inward upper Eyelid push on the Lower Eyelid margin during Eyelid closure is involved in involutional Lower Eyelid entropion.MethodsThis prospective observational study...
