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H P Adhikary - One of the best experts on this subject based on the ideXlab platform.

  • Congenital ptosis: A good cosmetic result with redefinition and suturing of the Orbital Septum
    Eye, 1996
    Co-Authors: A M Mcelvanney, H P Adhikary
    Abstract:

    A surgical technique employing Orbital Septum sutures during ptosis surgery in children is described. A retrospective study of 16 children (age range 6 months to 14 years) undergoing surgery for congenital ptosis over a 6 year period was undertaken with regard to cosmetic outcome. All surgery was performed by one consultant ophthalmic surgeon with the patient under general anaesthesia. A standard levator resection was undertaken, following which the Orbital Septum was redefined and sutured with interrupted 5-0 catgut. This resulted in a well-defined lid crease post-operatively, with a good cosmetic outcome. The only significant post-operative complication was the occurrence of a suture-related granuloma in one patient All achieved a good cosmetic result. A mild residual ptosis occurred in 3 cases, requiring a further procedure. Special attention to suturing of Orbital Septum as a separate tissue layer during levator resection for congenital ptosis gives good lid crease definition which may enhance the overall cosmetic outcome.

  • congenital ptosis a good cosmetic result with redefinition and suturing of the Orbital Septum
    Eye, 1996
    Co-Authors: A M Mcelvanney, H P Adhikary
    Abstract:

    Congenital ptosis: A good cosmetic result with redefinition and suturing of the Orbital Septum

A M Mcelvanney - One of the best experts on this subject based on the ideXlab platform.

  • Congenital ptosis: A good cosmetic result with redefinition and suturing of the Orbital Septum
    Eye, 1996
    Co-Authors: A M Mcelvanney, H P Adhikary
    Abstract:

    A surgical technique employing Orbital Septum sutures during ptosis surgery in children is described. A retrospective study of 16 children (age range 6 months to 14 years) undergoing surgery for congenital ptosis over a 6 year period was undertaken with regard to cosmetic outcome. All surgery was performed by one consultant ophthalmic surgeon with the patient under general anaesthesia. A standard levator resection was undertaken, following which the Orbital Septum was redefined and sutured with interrupted 5-0 catgut. This resulted in a well-defined lid crease post-operatively, with a good cosmetic outcome. The only significant post-operative complication was the occurrence of a suture-related granuloma in one patient All achieved a good cosmetic result. A mild residual ptosis occurred in 3 cases, requiring a further procedure. Special attention to suturing of Orbital Septum as a separate tissue layer during levator resection for congenital ptosis gives good lid crease definition which may enhance the overall cosmetic outcome.

  • congenital ptosis a good cosmetic result with redefinition and suturing of the Orbital Septum
    Eye, 1996
    Co-Authors: A M Mcelvanney, H P Adhikary
    Abstract:

    Congenital ptosis: A good cosmetic result with redefinition and suturing of the Orbital Septum

Kai Wang - One of the best experts on this subject based on the ideXlab platform.

  • downward rotation of the capsulopalpebral fascia Orbital Septum and Orbital fat complex a new technique for lower eyelid rejuvenation
    Plastic and reconstructive surgery. Global open, 2019
    Co-Authors: Zhenying Huang, Kai Wang
    Abstract:

    A single convex line without signs of bony landmarks presents a youthful contour appearance of the eyelid-cheek complex.1 Gradually, midcheek aging is characterized by progressive anatomic landmark changes, such as eye bags and lower lid orbitomalar sulcus depression (tear trough and lid-cheek junction),2–4 which present a tired appearance. The correction of those landmarks is very important in improving facial rejuvenation.5,6 In the history of lower blepharoplasty technique advances, there have been many surgical techniques designed to improve the most effective aesthetic results and to prevent postoperative complications.7 Surgical fat removal with lower lid skin excision was first performed in the early evolution of prominent lower eyelid fat management.8–11 Further, Loeb has popularized the fat sliding technique to achieve a more natural and comprehensive rejuvenation of the lower eyelid region.1,12–14 De la Plaza and Arroyo have been interested in fat preservation and tightening of the Orbital Septum techniques,15–17 because they described their capsulopalpebral fascia (CPF) repair technique for lower eyelid herniation in 1988. Although several surgical techniques are available, the correction of Orbital malar sulcus depression is still a challenge. In this article, the downward rotation technique of the capsulopalpebral fascia, Orbital Septum, and Orbital fat complex to orbitomalar sulcus depression can address a change of eyelid contour and create a more youthful and pleasing appearance. We describe this new surgical technique for lower eyelid blepharoplasty to preserve the lower eyelid fat and to more fully correct orbitomalar sulcus depression. In particular, this technique decreases the recurrence rate of palpebral bags.

Takashi Nakano - One of the best experts on this subject based on the ideXlab platform.

  • Orbital Septum attachment sites on the levator aponeurosis in asians and whites
    Ophthalmic Plastic and Reconstructive Surgery, 2010
    Co-Authors: Hirohiko Kakizaki, Takashi Nakano, Ken Asamoto, Dinesh Selva, Igal Leibovitch
    Abstract:

    Purpose: To characterize the attachment site of the Orbital Septum on the levator aponeurosis and the anatomic level of the inferior end of the preaponeurotic fat pad, both in Asians and whites. Materials and Methods: Full-thickness sagittal sections of upper eyelids, fixed in 10% buffered formalin, were microscopically examined in 18 postmortem upper eyelids of 10 Asian cadavers (mean death age, 78 years; age range, 68–89 years) and 11 postmortem upper eyelids of 7 whites (mean death age, 88 years; age range, 78–101 years). We measured the distance from the superior tarsal border to the attachment site of the Orbital Septum on the levator aponeurosis based on the position of the distal end of the anterior layer of the levator aponeurosis. In addition, the position of the inferior end of the preaponeurotic fat pad was simultaneously measured from the superior tarsal border. Results: The average distance from the superior tarsal border to the distal end of the anterior layer of the levator aponeurosis was 4.44 mm in Asians and 3.71 mm in whites (p = 0.412). The average distance from the superior tarsal plate border to the preaponeurotic fat pad was 1.90 mm in Asians and 3.17 mm in whites (p = 0.173). Conclusions: The distance from the Orbital Septum attachment site on the levator aponeurosis to the superior tarsal border is similar in Asians and whites. However, there is some tendency, although not statistically significant, to a lower extension of the preaponeurotic fat pad in Asians.

  • Orbital Septum attachment on the levator aponeurosis in asians in vivo and cadaver study
    Ophthalmology, 2009
    Co-Authors: Hirohiko Kakizaki, Ken Asamoto, Igal Leibovitch, Dinesh Selva, Takashi Nakano
    Abstract:

    Purpose To examine the anatomic relationships between the preaponeurotic fat pad, Orbital Septum, and the distal end of the anterior layer of the levator aponeurosis (DEALLA) in relation to the superior tarsal plate border. Design Prospective, clinical case series and experimental anatomic study. Participants Twenty-two upper eyelids in 11 Asian patients (average age, 76.5 years) and 10 postmortem upper eyelid specimens of 7 Asians (average age, 81 years). Methods The relationships between the Orbital Septum, DEALLA, preaponeurotic fat pad, and the superior tarsal plate border were examined in vivo, during upper blepharoplasty. In cadavers, the Orbital Septum was exposed and excised from the DEALLA, and the distance from the superior tarsal plate border to the DEALLA was measured at 3 points: the center of the palpebral width, and 2 points located 7 mm medial and lateral to the center. Main Outcome Measures The anatomic relationships of the Orbital Septum, DEALLA, and the preaponeurotic fat pad with the superior tarsal plate border. Results In vivo, the DEALLA was always located above the superior tarsal plate border, and the lower margin of the preaponeurotic fat was always positioned below the DEALLA and around the superior tarsal plate border. The lateral preaponeurotic fat in 4 eyelids showed extension beyond the superior tarsal border. In cadavers, the average distance from the superior tarsal plate border to the DEALLA was 3.7 mm centrally, 3.0 mm medially, and 0.9 mm laterally. In 3 specimens, the confluent part of the Orbital Septum and the levator aponeurosis reached the tarsus in the lateral area. Conclusions Orbital Septum attachment on the levator aponeurosis in Asians seems to be situated above the superior tarsal plate border in vivo, but the preaponeurotic fat extends beyond the DEALLA, sometimes reaching the tarsal plate. In some cadavers, the confluent part was found to be situated on the tarsus laterally. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.

  • Microscopic anatomy of Asian lower eyelids.
    Ophthalmic Plastic and Reconstructive Surgery, 2006
    Co-Authors: Hirohiko Kakizaki, Masahiro Zako, Osamu Miyaishi, Takashi Nakano, Ken Asamoto, Zhao Jinsong, Masayoshi Iwaki
    Abstract:

    PURPOSE: To elucidate the microscopic anatomy of the Asian lower eyelid. METHODS: Specimens (full-thickness sections of lower eyelids from 19 postmortem lower eyelids) from 11 Asians aged 73 to 96 years at death were fixed in 10% buffered formalin and microscopically examined. After pretreatment, sagittal sliced sections of the central part were stained with Masson trichrome. RESULTS: The distinct junction of the Orbital Septum to the capsulopalpebral fascia (CPF) was confirmed in 7 eyelids in which Orbital Septum was clearly stained, with an average distance from the tarsus to the junction of 2.38 mm. The other 12 eyelids did not show a distinct junction, and the Orbital Septum was poorly defined anteriorly and indistinct posteriorly. There was a distinct layer between the orbicularis oculi muscle and the Orbital Septum. The inferior and the posterior attachments of the CPF to the tarsus were seen in all eyelids. Seventeen of the 19 eyelids had attachment of the CPF on the anterior aspect of the tarsus, from which an extension of the CPF through the pretarsal orbicularis oculi muscle was observed. All eyelids had anterior extension of the CPF through the preseptal orbicularis oculi muscle, which was overridden on the pretarsal orbicularis oculi muscle. CONCLUSIONS: The microscopic findings of Asian lower eyelids, especially fascial components, were mostly similar to those of non-Asian eyelids, but differences existed in higher or indistinct Septum fusion, anterior and superior Orbital fat projection, and the overriding of the preseptal orbicularis oculi muscle.

  • posterior aspect of the Orbital Septum is reinforced by ligaments
    Japanese Journal of Ophthalmology, 2005
    Co-Authors: Hirohiko Kakizaki, Masahiro Zako, Osamu Miyaishi, Takashi Nakano, Ken Asamoto, Masayoshi Iwaki
    Abstract:

    To investigate the ligaments reinforcing the posterior aspect of the Orbital Septum. Sixteen upper eyelids of eight cadavers of Asians were dissected. Ten were subjected to gross dissections to investigate the ligaments attached to the posterior aspect of the Orbital Septum and to investigate the relationships with the associated ligamentous structures, and six were used for histological sections to elucidate the ligament anchoring sites in the Septum. The ligaments were attached to the posterior aspect of the Orbital Septum in both upper and lower eyelids in all cases. Some septa in the upper eyelids were supported by the lower-positioned transverse ligament in the lateral area. In all cases, part of the Lockwood ligament was attached to the posterior aspect of the Orbital Septum in the lower eyelids. Histologically, the ligaments were anchored to the posterior aspect of the Orbital Septum. The ligaments were attached to the posterior aspect of the Orbital Septum. These ligaments, in cooperation with the associated ligaments, are thought to complement the fragility of the Orbital Septum. Jpn J Ophthalmol 2005;49:477–480 © Japanese Ophthalmological Society 2005

  • Posterior Aspect of the Orbital Septum Is Reinforced by Ligaments
    Japanese Journal of Ophthalmology, 2005
    Co-Authors: Hirohiko Kakizaki, Masahiro Zako, Osamu Miyaishi, Takashi Nakano, Ken Asamoto, Masayoshi Iwaki
    Abstract:

    Purpose To investigate the ligaments reinforcing the posterior aspect of the Orbital Septum. Methods Sixteen upper eyelids of eight cadavers of Asians were dissected. Ten were subjected to gross dissections to investigate the ligaments attached to the posterior aspect of the Orbital Septum and to investigate the relationships with the associated ligamentous structures, and six were used for histological sections to elucidate the ligament anchoring sites in the Septum. Results The ligaments were attached to the posterior aspect of the Orbital Septum in both upper and lower eyelids in all cases. Some septa in the upper eyelids were supported by the lower-positioned transverse ligament in the lateral area. In all cases, part of the Lockwood ligament was attached to the posterior aspect of the Orbital Septum in the lower eyelids. Histologically, the ligaments were anchored to the posterior aspect of the Orbital Septum. Conclusions The ligaments were attached to the posterior aspect of the Orbital Septum. These ligaments, in cooperation with the associated ligaments, are thought to complement the fragility of the Orbital Septum. Jpn J Ophthalmol 2005;49:477–480 © Japanese Ophthalmological Society 2005

Hirohiko Kakizaki - One of the best experts on this subject based on the ideXlab platform.

  • Orbital Septum attachment sites on the levator aponeurosis in asians and whites
    Ophthalmic Plastic and Reconstructive Surgery, 2010
    Co-Authors: Hirohiko Kakizaki, Takashi Nakano, Ken Asamoto, Dinesh Selva, Igal Leibovitch
    Abstract:

    Purpose: To characterize the attachment site of the Orbital Septum on the levator aponeurosis and the anatomic level of the inferior end of the preaponeurotic fat pad, both in Asians and whites. Materials and Methods: Full-thickness sagittal sections of upper eyelids, fixed in 10% buffered formalin, were microscopically examined in 18 postmortem upper eyelids of 10 Asian cadavers (mean death age, 78 years; age range, 68–89 years) and 11 postmortem upper eyelids of 7 whites (mean death age, 88 years; age range, 78–101 years). We measured the distance from the superior tarsal border to the attachment site of the Orbital Septum on the levator aponeurosis based on the position of the distal end of the anterior layer of the levator aponeurosis. In addition, the position of the inferior end of the preaponeurotic fat pad was simultaneously measured from the superior tarsal border. Results: The average distance from the superior tarsal border to the distal end of the anterior layer of the levator aponeurosis was 4.44 mm in Asians and 3.71 mm in whites (p = 0.412). The average distance from the superior tarsal plate border to the preaponeurotic fat pad was 1.90 mm in Asians and 3.17 mm in whites (p = 0.173). Conclusions: The distance from the Orbital Septum attachment site on the levator aponeurosis to the superior tarsal border is similar in Asians and whites. However, there is some tendency, although not statistically significant, to a lower extension of the preaponeurotic fat pad in Asians.

  • Orbital Septum attachment on the levator aponeurosis in asians in vivo and cadaver study
    Ophthalmology, 2009
    Co-Authors: Hirohiko Kakizaki, Ken Asamoto, Igal Leibovitch, Dinesh Selva, Takashi Nakano
    Abstract:

    Purpose To examine the anatomic relationships between the preaponeurotic fat pad, Orbital Septum, and the distal end of the anterior layer of the levator aponeurosis (DEALLA) in relation to the superior tarsal plate border. Design Prospective, clinical case series and experimental anatomic study. Participants Twenty-two upper eyelids in 11 Asian patients (average age, 76.5 years) and 10 postmortem upper eyelid specimens of 7 Asians (average age, 81 years). Methods The relationships between the Orbital Septum, DEALLA, preaponeurotic fat pad, and the superior tarsal plate border were examined in vivo, during upper blepharoplasty. In cadavers, the Orbital Septum was exposed and excised from the DEALLA, and the distance from the superior tarsal plate border to the DEALLA was measured at 3 points: the center of the palpebral width, and 2 points located 7 mm medial and lateral to the center. Main Outcome Measures The anatomic relationships of the Orbital Septum, DEALLA, and the preaponeurotic fat pad with the superior tarsal plate border. Results In vivo, the DEALLA was always located above the superior tarsal plate border, and the lower margin of the preaponeurotic fat was always positioned below the DEALLA and around the superior tarsal plate border. The lateral preaponeurotic fat in 4 eyelids showed extension beyond the superior tarsal border. In cadavers, the average distance from the superior tarsal plate border to the DEALLA was 3.7 mm centrally, 3.0 mm medially, and 0.9 mm laterally. In 3 specimens, the confluent part of the Orbital Septum and the levator aponeurosis reached the tarsus in the lateral area. Conclusions Orbital Septum attachment on the levator aponeurosis in Asians seems to be situated above the superior tarsal plate border in vivo, but the preaponeurotic fat extends beyond the DEALLA, sometimes reaching the tarsal plate. In some cadavers, the confluent part was found to be situated on the tarsus laterally. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.

  • Microscopic anatomy of Asian lower eyelids.
    Ophthalmic Plastic and Reconstructive Surgery, 2006
    Co-Authors: Hirohiko Kakizaki, Masahiro Zako, Osamu Miyaishi, Takashi Nakano, Ken Asamoto, Zhao Jinsong, Masayoshi Iwaki
    Abstract:

    PURPOSE: To elucidate the microscopic anatomy of the Asian lower eyelid. METHODS: Specimens (full-thickness sections of lower eyelids from 19 postmortem lower eyelids) from 11 Asians aged 73 to 96 years at death were fixed in 10% buffered formalin and microscopically examined. After pretreatment, sagittal sliced sections of the central part were stained with Masson trichrome. RESULTS: The distinct junction of the Orbital Septum to the capsulopalpebral fascia (CPF) was confirmed in 7 eyelids in which Orbital Septum was clearly stained, with an average distance from the tarsus to the junction of 2.38 mm. The other 12 eyelids did not show a distinct junction, and the Orbital Septum was poorly defined anteriorly and indistinct posteriorly. There was a distinct layer between the orbicularis oculi muscle and the Orbital Septum. The inferior and the posterior attachments of the CPF to the tarsus were seen in all eyelids. Seventeen of the 19 eyelids had attachment of the CPF on the anterior aspect of the tarsus, from which an extension of the CPF through the pretarsal orbicularis oculi muscle was observed. All eyelids had anterior extension of the CPF through the preseptal orbicularis oculi muscle, which was overridden on the pretarsal orbicularis oculi muscle. CONCLUSIONS: The microscopic findings of Asian lower eyelids, especially fascial components, were mostly similar to those of non-Asian eyelids, but differences existed in higher or indistinct Septum fusion, anterior and superior Orbital fat projection, and the overriding of the preseptal orbicularis oculi muscle.

  • posterior aspect of the Orbital Septum is reinforced by ligaments
    Japanese Journal of Ophthalmology, 2005
    Co-Authors: Hirohiko Kakizaki, Masahiro Zako, Osamu Miyaishi, Takashi Nakano, Ken Asamoto, Masayoshi Iwaki
    Abstract:

    To investigate the ligaments reinforcing the posterior aspect of the Orbital Septum. Sixteen upper eyelids of eight cadavers of Asians were dissected. Ten were subjected to gross dissections to investigate the ligaments attached to the posterior aspect of the Orbital Septum and to investigate the relationships with the associated ligamentous structures, and six were used for histological sections to elucidate the ligament anchoring sites in the Septum. The ligaments were attached to the posterior aspect of the Orbital Septum in both upper and lower eyelids in all cases. Some septa in the upper eyelids were supported by the lower-positioned transverse ligament in the lateral area. In all cases, part of the Lockwood ligament was attached to the posterior aspect of the Orbital Septum in the lower eyelids. Histologically, the ligaments were anchored to the posterior aspect of the Orbital Septum. The ligaments were attached to the posterior aspect of the Orbital Septum. These ligaments, in cooperation with the associated ligaments, are thought to complement the fragility of the Orbital Septum. Jpn J Ophthalmol 2005;49:477–480 © Japanese Ophthalmological Society 2005

  • Posterior Aspect of the Orbital Septum Is Reinforced by Ligaments
    Japanese Journal of Ophthalmology, 2005
    Co-Authors: Hirohiko Kakizaki, Masahiro Zako, Osamu Miyaishi, Takashi Nakano, Ken Asamoto, Masayoshi Iwaki
    Abstract:

    Purpose To investigate the ligaments reinforcing the posterior aspect of the Orbital Septum. Methods Sixteen upper eyelids of eight cadavers of Asians were dissected. Ten were subjected to gross dissections to investigate the ligaments attached to the posterior aspect of the Orbital Septum and to investigate the relationships with the associated ligamentous structures, and six were used for histological sections to elucidate the ligament anchoring sites in the Septum. Results The ligaments were attached to the posterior aspect of the Orbital Septum in both upper and lower eyelids in all cases. Some septa in the upper eyelids were supported by the lower-positioned transverse ligament in the lateral area. In all cases, part of the Lockwood ligament was attached to the posterior aspect of the Orbital Septum in the lower eyelids. Histologically, the ligaments were anchored to the posterior aspect of the Orbital Septum. Conclusions The ligaments were attached to the posterior aspect of the Orbital Septum. These ligaments, in cooperation with the associated ligaments, are thought to complement the fragility of the Orbital Septum. Jpn J Ophthalmol 2005;49:477–480 © Japanese Ophthalmological Society 2005