Upper Eyelid and Orbital Involvement in Congenital Infiltrating Lipomatosis.

Congenital infiltrating lipomatosis of the face is a rare entity that has not been reported in the ophthalmic literature. The authors describe two patients affected by this condition. Diagnosis and management of congenital infiltrating lipomatosis of the face involving the eye adnexa is challenging and the psychological impact on such patients must be considered. [J Pediatr Ophthalmol Strabismus. 2022;59(3):e46-e49.].

Large Conjunctival Inclusion Cyst after Anterior Approach Ptosis Surgery.

An 8-year-old male child who underwent an anterior approach left upper lid levator resection to correct congenital ptosis. After 6 months, he developed mechanical ptosis secondary to a painless cystic mass on his upper lid. Magnetic resonance proved a postseptal circumscribed cystic mass. The lesion was excised and a histopathology examination confirmed a conjunctival inclusion cyst (CIC). CIC is common benign lesions of conjunctiva but rarely detected as a complication of levator muscle surgery.

One Triangle-Blepharoplasty Flap for Anterior Lamellae Pretarsal Defects on the Upper Eyelid.

PURPOSE: The aim of this study is to present the outcomes of one triangle blepharoplasty flap upper eyelid (UE) reconstruction. It is a hardly recognized technique used to repair anterior lamella pretarsal defects resulting from the removal of lesions on the UE. METHODS: Retrospective review of three excised lesions reconstructed with one triangle-blepharoplasty flap technique between 2017 and 2020 at Río Hortega University Hospital in Valladolid, Spain. It is a technique to reconstruct wide-based anterior lamella UE lesions, 25% to 50% UE length. Demographic characteristics, histology results and complications are presented. RESULTS: Medical records of three patients have been reviewed with a minimum follow-up of 6 months (mean follow up of 16 months). The patient's average age was 67 years. Histology results were three seborrheic keratosis. There were no intra or post-surgical complications and all had good functional and aesthetic upper lid results. CONCLUSIONS: The reconstruction of pretarsal lesions limited to the anterior lamella of the UE using one triangle-blepharoplasty flap is a technique with good functional and aesthetic results.

Changes in Lower Lid Position after Standard Phacoemulsification Cataract Surgery.

PURPOSE: To evaluate the changes on the position of the lower lid after phacoemulsification surgery using objective methods. METHODS: This prospective study evaluated the lower lid position of cataract carriers who underwent to phacoemulsification surgery from January to May 2017. Data were collected on demographics, type of anesthesia, duration of the surgical procedure, and duration of the speculum remained in place. Standardized digital photographs of the patient's face in primary gaze position were obtained preoperatively and 1, 30, 90, and 180 days, postoperatively. The data were analyzed on the distraction test, distance of the lower lacrimal punctum from the inner canthus, and margin reflex distance 2 (MRD2). Comparative and correlation statistical analyses involving preoperative and postoperative measurements were performed. RESULTS: One hundred twelve cataract patients comprised the study sample. There were 68 (60.7%) females with a median age of 74 (interquartile range, 70-81) years old. The mean distraction test value before surgery was 7 ± 2 mm and 6.8 ± 1.8 mm 180 days postoperatively (P = 0.02). The mean lacrimal lower punctum distance changed from 5 ± 1.1 mm preoperatively to 5.4 ± 1 mm at 180 days postoperatively (P = 0.06). The mean MRD2 preoperatively was 5 ± 1 mm and increased to 5.4 ± 0.9 mm 180 days after surgery (P = 0.02). The duration of surgery and the duration that speculum remained in place were not correlated to MRD2 (P = 0.7; P = 0.98). CONCLUSIONS: There is a mild lower lid laxity after phacoemulsification reflected by slight increased lacrimal lower punctum distance to the inner canthus and MRD2. Lacrimal lower punctum distance and MRD2 vary along the study and remained altered at 180 days after surgery, while distraction test tends to recover to similar preoperative levels. Although lid laxity is common in elderly cataract carriers, even a short procedure as phacoemulsification can mildly increase flaccidity.