A Magnetic Actuator Device for Fully Automated Blinking in Total Bidirectional Eyelid Paralysis: First Proof of Concept in a Human Participant.

Purpose: Currently, no solution exists to restore natural eyelid kinematics for patients with complete eyelid paralysis due to loss of function of both the levator palpebrae superioris and orbicularis oculi. These rare cases are prone to complications of chronic exposure keratopathy which may lead to corneal blindness. We hypothesized that magnetic force could be used to fully automate eyelid movement in these cases through the use of eyelid-attached magnets and a spectacle-mounted magnet driven by a programmable motor (motorized magnetic levator prosthesis [MMLP]). Methods: To test this hypothesis and establish proof of concept, we performed a finite element analysis (FEA) for a prototype MMLP to check the eyelid-opening force generated by the device and verified the results with experimental measurements in a volunteer with total bidirectional eyelid paralysis. The subject was then fitted with a prototype to check the performance of the device and its success. Results: With MMLP, eye opening was restored to near normal, and blinking was fully automated in close synchrony with the motor-driven polarity reversal, with full closure on the blink. The device was well tolerated, and the participant was pleased with the comfort and performance. Conclusions: FEA simulation results conformed to the experimentally observed trend, further supporting the proof of concept and design parameters. This is the first viable approach in human patients with proof of concept for complete reanimation of a bidirectionally paretic eyelid. Further study is warranted to refine the prototype and determine the feasibility and safety of prolonged use. Translational Relevance: This is first proof of concept for our device for total bidirectional eyelid paralysis.

Assessing neophyte response to daily disposable silicone hydrogel contact lenses: A randomised clinical trial investigation over one month.

OBJECTIVE: This randomised clinical trial assessed the impact on symptoms, tear film dynamics and ocular surface integrity of daily disposable silicone-hydrogel contact lenses (CLs) over a month, paying special attention to lid wiper epitheliopathy (LWE) and its implications for CL discomfort. METHODS: Neophyte CL wearers (n = 44, 21.09 ± 5.00 years old) were randomly assigned to either the experimental (n = 24) or control group (n = 20). Participants assigned to the experimental group were required to wear daily disposable CLs for 1 month for at least 8 h/day and 6 days/week. All participants were healthy subjects (no history of ocular surgery or active ocular disease) with spherical refractive errors between -8.00 and +5.00 D and cylindrical power <0.75 D. At the baseline and 1-month sessions, the Dry Eye Questionnaire 5 (DEQ-5) was completed, together with the measurement of tear film osmolarity with the TearLab osmometer, tear meniscus height (TMH) and lipid layer pattern (LLP) using a slit-lamp with Tearscope Plus attached, fluorescein break-up time (FBUT), maximum blink interval (MBI), corneal staining with fluorescein under cobalt blue light and LWE with lissamine green under slit lamp and halogen white light. RESULTS: At the baseline session, LWE showed a negative correlation with DEQ-5 (r = -0.37, p = 0.02). Significant differences in FBUT and LWE (p = 0.04) and a positive correlation between LWE and DEQ-5 (r = 0.49, p = 0.007) were observed at 1 month. Intrasession analysis at 1 month showed significant differences between the experimental and control groups in DEQ-5, FBUT and LWE (all p ≤ 0.02). Intersession analysis in the experimental group showed variations in DEQ-5, FBUT and LWE (all p ≤ 0.02) but no significant variation in the control group (all p ≥ 0.11). CONCLUSION: The presence of LWE was significantly correlated with higher symptom values in the DEQ-5. Also, participants in the experimental group presented higher values of LWE after 1 month of CL wear, in comparison with the control group.

Blink Lagophthalmos in Graves Orbitopathy.

PURPOSE: To investigate the relationship between the kinematics of spontaneous blinks and the anterior area of the levator palpebrae superioris muscle in patients with Graves orbitopathy (GO). METHODS: This is a case-control study. The authors measured the margin reflex distance of the upper eyelid (margin reflex distance 1), the kinematics of spontaneous blinks, and the anterior area of levator palpebrae superioris muscle in CT coronal scans of patients with Graves upper eyelid retraction (GO) and a control group. The eye with the greatest margin reflex distance 1 was selected for analysis in each group. RESULTS: A total of 68 participants were included, with 36 in the GO group and 32 in the control group. In the GO group, the mean margin reflex distance 1 measured 6.5 mm, while in the control group, it was 3.9 mm. Almost all parameters related to the closing phase of spontaneous blinking activity, including amplitude, velocity, blinking rate, and interblink time, did not differ between the two groups. However, the effectiveness of the blink's amplitude (ratio of blink amplitude to margin reflex distance 1) and the main sequence (relationship between amplitude and velocity) were significantly reduced in the GO group compared with the control group. The area of the levator palpebrae superioris muscle was significantly larger in GO than in controls, with 71.4% of patients' muscles outside of the maximum range of the controls. CONCLUSIONS: In patients with GO, there is a reduction in blinking effectiveness, also known as blink lagophthalmos, which is a factor in the common occurrence of ocular surface symptoms. The increase in velocity with amplitude is also reduced in GO.

Outcome Comparison of Transconjunctival Müller's Muscle Recession With Levator Disinsertion (TMRLD) to Gold Weight Implantation in the Treatment of Paralytic Lagophthalmos.

PURPOSE: To compare clinical outcomes of transconjunctival Müller's muscle recession with levator disinsertion (TMRLD) to the traditional gold weight implantation in patients with paralytic lagophthalmos. METHODS: A retrospective nonrandomized comparative review of patients who had gold weight implantation and TMRLD surgeries for paralytic lagophthalmos from January 2016 to January 2023 was performed. The main outcome comparisons were measurement changes in lagophthalmos, marginal reflex distance 1, visual acuity, and corneal examination. Complication and reoperation rates were also compared. RESULTS: Twenty-six cases of gold weight implantation and 20 cases of TMRLD surgeries were identified. The changes in logMAR visual acuity between gold weight implantation and TMRLD groups were not statistically significant (-0.10 ± 0.48 vs. +0.05 ± 0.14, p > 0.05). The percent improvement in lagophthalmos (62.2% ± 51.8% vs. 58.4% ± 21.1%) and final marginal reflex distance 1 (2.22 ± 1.42 vs. 2.25 ± 1.41 mm) were also comparable between groups ( p > 0.05). Both groups showed similar changes in marginal reflex distance 1 (1.75 ± 1.31 vs. 2.83 ± 1.37 mm) and lagophthalmos (3.77 ± 3.92 vs. 3.36 ± 1.36 mm) ( p > 0.05). The overall complication (15.4% vs. 15.0%) and reoperation rates (15.4% vs. 15.0%) were comparable over the follow-up duration (291.6 ± 437.3 vs. 121.0 ± 177.8 days) ( p > 0.05). CONCLUSION: TMRLD is as safe and effective as the gold weight implantation in addressing paralytic lagophthalmos in patients with facial nerve palsy.

Intra- and interobserver reliability of a modified distraction test based on digital images to assess lower eyelid horizontal tension / Confiabilidade intra e interobservador do teste de tração modificado para avaliar a tensão da pálpebra inferior baseado em imagens digitais

ABSTRACT Purpose: Inferior eyelid laxity is classically evaluated using "snap-back" and "distraction" tests. This study aimed to assess the reproducibility of the technique used to indirectly quantify the horizontal tension in the lower eyelids using digital image processing. Methods: This longitudinal study was conducted to assess the reproducibility of a new technique that quantifies the horizontal tension in the lower eyelid. The study was conducted at the Hospital das Clínicas of Porto Alegre. The protocol was established by two trained ophthalmologist examiners, allowing intra- and interobserver agreement analyses. Image acquisition was done in two stages: the first image was captured with the eyelid in primary gaze position and the second with the eyelid in traction position. All images and measurements were processed using Image J 1.33m software from the National Institute of Health. The Bland-Altman method, intraclass correlation coefficients, concordance correlation coefficients, and technical measurement error were used to evaluate reproducibility. Results: The study participants comprised healthy individuals with no ophthalmologic pathologies. The measurements obtained in the neutral position showed a slightly higher agreement than those obtained in the traction position. The mean difference between the measurements performed in the traction position was 0.028 ± 0.7 mm and 0.014 ± 0.9 mm in the intra- and interobserver analyses, respectively. The Bland-Altman method demonstrated adequate confidence limits for both measurements. Correlation coefficients for measurements varied between 0.87 [95% confidence interval (CI) 0.68-0.95] and 0.91 (95% CI 0.77-0.97) in the neutral position and between 0.72 (95% CI 0.37-0.89) and 0.76 (95% CI 0.4-0.91) in the traction position. Conclusion: A high intra- and interobserver concordance was observed in the studied method to quantify lower eyelid tension. The proposed method is simple and easily reproducible, and to the best our knowledge, this is the first method that quantifies lower eyelid horizontal tension on the basis of digital image processing. This modified distraction test might be useful in studies quantifying lower eyelid horizontal tension.

RESUMO Objetivo: A frouxidão palpebral inferior é avaliada classicamente por meio de testes de "snap-back" e "distraction test". O objetivo deste estudo foi avaliar a reprodutibilidade da técnica utilizada para quantificar indiretamente a tensão horizontal nas pálpebras inferiores através do processamento digital de imagens. Métodos: Este estudo longitudinal foi realizado para avaliar a reprodutibilidade de uma nova técnica que quantifica a tensão horizontal na pálpebra inferior. O estudo foi realizado no Hospital das Clínicas de Porto Alegre. O protocolo foi estabelecido por dois examinadores oftalmologistas treinados, permitindo análises de concordância intra e interavaliador. A aquisição de imagens foi feita em duas etapas: a primeira imagem foi capturada com a pálpebra na posição primária do olhar e a segunda com pálpebra tracionada. Todas as imagens e medições foram processadas usando o software Image J 1.33m do National Institute of Health. O método de Bland-Altman, os coeficientes de correlação intraclasses, os coeficientes de correlação de concordância e o erro técnico da medida foram utilizados para avaliar a reprodutibilidade. Resultados: Os participantes do estudo foram indivíduos saudáveis e sem patologias oftalmológicas. As medidas obtidas na posição neutra mostraram concordância levemente maior do que as obtidas na posição tracionada. A diferença média entre as medidas realizadas na posição tracionada foi de 0,028 ± 0,7mm e 0,014 ± 0,9mm nas análises intra e interobservadores, respectivamente. O método de Bland-Altman demonstrou limites de confiança adequados para ambas as medidas. Os coeficientes de correlação para as medidas variaram entre 0,87 [intervalo de confiança de 95% (IC) 0,68-0,95) e 0,91 (IC 95% 0,77-0,97) na posição neutra e entre 0,72 (IC 95% 0,37-0,89) e 0,76 (IC 95% 0,46-0,91) na posição tracionada. Conclusão: Observou-se elevada concordância intra e interobservador no método estudado para quantificar a tensão palpebral inferior. O método proposto é simples e facilmente reproduzível, e, do melhor modo possível, este é o primeiro método que quantifica a tensão horizontal da pálpebra inferior com base no processamento digital de imagens. Este teste de distração modificado pode ser útil em estudos que quantifiquem a tensão horizontal da pálpebra inferior.

The eyelash follicle features and anomalies: A review / Características y anomalías del folículo de la pestaña: revisión

The primary role of eyelashes is to protect and maintain the health of the lid margin. However, the mechanisms to fulfill this role are not fully understood. Unraveling these mechanisms will stand to greatly improve the efficiency of eye care professionals’ interventions in anomalies of the eyelashes. The aim of this article is to provide a review on eyelashes including highlights and new avenues for research; the biology of both the lash and its follicle; the pathophysiology and management of lash anomalies by eye care professionals; and the effect of iatrogenic factors on lashes. Using the database of Ovid MEDLINE, we reviewed studies specifically directed on human/mammalian eyelashes and key articles on current trends in scalp hair methodologies that can be applicable to lash research. The eyelash morphology, pigmentation and growth rate have been documented using techniques ranging from lash imaging to follicle immunohistochemistry. Furthermore, studies have demonstrated that the lash follicle is sensitive to many factors of the external environment, a variety of systemic/topical medications and cosmetics. Recently, aerodynamic studies using a mammalian eye model confirmed that an optimal lash length was needed so that eyelashes serve a protective role in reducing the number of particles that can reach the eye. Despite recent advances in lash research, studies are still scarce, due to the limited availability of the human lid for sampling. This review brings awareness that further research is needed with respect to eyelashes and will hopefully reduce the gap with scalp hair research

La función principal de las pestañas es proteger y mantener la salud del margen palpebral. Sin embargo, los mecanismos de desempeño de esta función no se comprenden plenamente. Desentrañar estos mecanismos ayudará a mejorar la eficiencia de las intervenciones de los profesionales de cuidados oculares en cuanto a las anomalías de las pestañas. El objetivo de este artículo es aportar una revisión sobre las pestañas, incluyendo los aspectos más destacados y las nuevas aportaciones para la investigación, la biología de la pestaña y su folículo, la patofisiología y tratamiento de las anomalías de las pestañas por parte de los profesionales de cuidados oculares, y el efecto de los factores iatrogénicos sobre las pestañas. Utilizando la base de datos de Ovid MEDLINE, revisamos los estudios específicamente dirigidos a las pestañas humanas/de mamíferos, así como los artículos clave sobre las tendencias actuales en cuanto a las metodologías del cuero cabelludo, que pueden aplicarse a la investigación sobre las pestañas. Se han documentado la morfología de las pestañas, así como su pigmentación y tasa de crecimiento, utilizando técnicas que oscilan entre la imagen de las pestañas y la inmunohistoquímica del folículo. Además, los estudios han demostrado que el folículo de la pestaña es sensible a diversos factores del entorno externo, diversas medicaciones sistémicas/tópicas y cosméticos. Recientemente, los estudios aerodinámicos que han utilizando un modelo de ojo de mamífero, han confirmado que se precisaba una longitud de pestañas óptima para que éstas ejercieran su función protectora a la hora de reducir el número de partículas que pueden acceder al ojo. A pesar de los avances recientes de la investigación sobre las pestañas, los estudios son aún escasos, debido a la disponibilidad limitada de párpado humano para muestreo. Esta revisión sirve de concienciación acerca de la necesidad de investigación futura con respecto a las pestañas, que reducirá presumiblemente la brecha existente con respecto a la investigación sobre el cuero cabelludo

Eyelid aging: pathophysiology and clinical management / Envelhecimento palpebral: fisiopatologia e considerações clínicas

ABSTRACTLife expectancy is increasing in most countries. With increasing age, many individuals may develop involutional ophthalmic diseases, such as eyelid aging. Dermatochalasis, ptosis, ectropion, and entropion are common disorders in middle-aged and older adults. This review outlines the pathophysiology and clinical management of these involutional eyelid disorders. Recently, a decrease in elastic fibers with ultrastructural abnormalities and an overexpression of elastin-degrading enzymes have been demonstrated in involutional ectropion and entropion. This may be the consequence of local ischemia, inflammation, and/or chronic mechanical stress. Eyelid aging with progressive loss of tone and laxity may affect the ocular surface and adnexal tissues, resulting in different clinical symptoms and signs. Surgical management depends on the appropriate correction of the underlying anatomical defect.

RESUMOA expectativa de vida está aumentando na maioria dos países. Com o envelhecimento, muitos indivíduos desenvolverão doenças oculares crônicas e involucionais, tais como o envelhecimento palpebral. Dermatocálase, ptose, ectrópio e entrópio são doenças frequentes em adultos e idosos. Esta revisão destaca a fisiopatologia e a clínica de doenças palpebrais involucionais. Recentemente, uma diminuição de fibras elásticas com anormalidades ultraestruturais e um aumento de enzimas degradantes de elastina foram demonstrados em ectrópio e entrópio involucionais. Isto pode ser consequência de isquemia local, inflamação e/ou estresse mecânico crônico. O envelhecimento palpebral com perda progressiva de tônus e flacidez pode afetar a superfície ocular e os anexos oculares, resultando em sinais e sintomas clínicos diferentes. O tratamento cirúrgico depende da correção apropriada do defeito anatômico subjacente.

Ocular leprosy

Ocular involvement in leprosy is estimated to be 70-75%, about 10-50% of leprosy patients suffer from severe ocular symptoms, and blindness occurs in about 5% of patients. The disease leads to many ophthalmologic symptoms and signs in the range of the eyeball itself, as well as of the bulb adnexa, ie, eyebrows, eyelids with eyelashes, and lacrimal drainage system. Especially dangerous are complications of lagophthalmos and corneal hypoanesthesia, neurotrophic or infectious keratitis, and iridocyclitis and cataract formation, which may lead to significant decrease of visual acuity or even blindness. Multidrug treatment rapidly interrupts transmission of Mycobacterium leprae by infectious patients, but even after being completed, it does not guarantee the withholding of ocular complications.

Floppy eyelid syndrome: review / Síndrome da frouxidão palpebral: revisão da literatura

Floppy eyelid syndrome is characterized by the easy evertion of the upper eyelid which occurs spontaneously during the sleep, causing the exposure of the eye surface and chronic papillary conjunctivitis. Its pathogenesis is not totally defined yet: it is usually more frequent in middle-aged, male obese patients and it is associated with systemic disorders such as obstructive sleep apnea, high blood pressure and diabetes. On the occasions which conservative treatment fails, surgical procedures present good results, including surgical techniques which are constantly evolving.

A síndrome de frouxidão palpebral é caracterizada pela fácil eversão da pálpebra que ocorre espontaneamente durante o sono causando exposição dos olhos, com consequente conjuntivite papilar crônica. Sua patogênese ainda não está totalmente definida e é mais comum em pacientes masculinos, obesos, de meia idade e está associada a doenças sistêmicas como apnéia obstrutiva do sono, hipertensão arterial e diabetes. Quando o tratamento clínico não apresenta boa resposta, procedimentos cirúrgicos apresentam bons resultados, com técnicas em constante evolução.

Diminuição da função do músculo levantador da pálpebra superior em pacientes submetidos à cirurgia de ptose palpebral involucional e dermatocálase / Decrease of upper eyelid levator muscle function after involutional ptosis and dermatochalasis surgery

OBJETIVO: Avaliar a diferença da função do músculo levantador da pálpebra superior (FMLPS), distância margem reflexo (DMR1) e altura do sulco palpebral (AS) antes e depois da cirurgia de blefaroplastia superior associada à correção de ptose palpebral. MÉTODOS: Quarenta e quatro pacientes com blefaroptose e dermatocálase foram incluídos. Intervenção: exploração do tendão do músculo levantador da pálpebra superior (MLPS) durante a blefaroplastia, em portadores de blefaroptose e dermatocálase. Nos casos de desinserção, o tendão foi refixado ao tarso. Desfechos analisados: foram analisados de forma bilateral a diferença entre FMLPS, DMR1 e AS antes e depois da intervenção. A dependência entre os olhos foi corrigida por meio de equações de estimativa generalizada. Foi utilizada a correlação de Pearson para quantificar a dependência entre os olhos para FMLPS, DMR1 e AS. RESULTADOS: Houve diferença significante entre as medidas de FMLPS antes e depois da cirurgia, havendo redução da excursão do MLPS após a cirurgia, diminuindo, em média, 1,1 mm (P<0,001). As medidas pré e pós-operatória de DMR1 e AS foram estatisticamente diferentes, sendo que a DMR1 aumentou, em média, 1,6 mm e a AS diminuiu, em média, 3,97 mm (P<0,001) após a cirurgia. Houve correlação significante entre os olhos para todas as variáveis propedêuticas antes e depois da cirurgia. As correlações pré-operatórias foram mais fortes no grupo sem cirurgia prévia. O mesmo foi encontrado para a correlação quanto ao grau de desinserção nos dois olhos (P>0,01). CONCLUSÃO: A função do músculo levantador da pálpebra superior diminui após a cirurgia para a correção da ptose.

PURPOSE: To evaluate the differences between upper eyelid levator muscle function (UELMF), margin reflex distance (MDR1), and eyelid crease height (ECH) before and after ptosis and dermatochalasis surgery. METHODS: Forty-four patients with blepharoptosis and dermatochalasis were enrolled. Intervention: An exploration of the levator tendon (LT) during a blepharoplasty procedure in patients with blepharoptosis and dermatochalasis and in case of its disinsertion, the tendon was reattached to the tarsus. Measured outcome: The differences between UELMF, MDR1, ECH before and after surgery were evaluated bilaterally. Dependency between both eyes was corrected by generalized estimating equations. Pearson correlation was used to evaluate the dependency of the two eyes regarding UELMF, MDR1 and ECH. RESULTS: There was a statistical significant difference between the measures of UELMF before and after surgery with excursion decreasing by a mean value of 1.1 mm after the procedure (P<0.001). Measures of MDR1 showed an increase by a mean of 1.6 mm and ECH decreased by a mean of 3.97 mm (P<0.001). We found a significant correlation between both eyes for all analyzed eyelid variables, both before and after surgery. Correlation before surgery was stronger for the group without previous surgery. The same results for correlation were found for the amount of disinsertion (P>0.001). CONCLUSIONS: Upper eyelid levator muscle function decreases after ptosis surgery.

Un enfoque holístico de las enfermedades de la superficie ocular / A holistic approach for ocular surface diseases

La transparencia comeal es producto de un complejo sistema de interacciones. El conocimiento de estas es muy importante para establecer una terapia adecuada para patologías tan diversas como son la disfunción lagrimal, el haze comeal post PRK, y el rechazo comeal. La conjuntiva y el epitelio comeal indemnes son imprescindibles para mantener la función del sistema ocular. A su vez la integridad de estas estructuras depende de la integridad de párpados y lágrimas. Actualmente sabemos que la interacción entre estos cuatro componentes permite mantener en equilibrio la homeostasis de la superficie ocular. Asegurando la indemnidad de las células progenitoras límbicas. La alteración en cualquiera de estos factores produce ojo rojo, infecciones, mayor predisposición a úlceras, y alteraciones de la epitelización. Desequilibrios en el funcionamiento de este sistema se engloban hoy como enfermedades de la superficie ocular, y están dando origen a una nueva subespecialidad. Ya que los avances en el conocimiento de la fisiopatología de la lagrima y de su interacción con la come a, han permitido el desarrollo de una mirada más racional de la patología de este segmento creemos interesante revisar este conjunto de desordenes y proponer una aproximación terapéutica.

Comeal transparency is own to a complex system of interactions. Settle the right therapeutic approach in quite different pathologies as comeal haze, comeal rejection and tears disfunction, is related with the knowledge ofthese relationships. Comeal and conjunctival epithelium integrity is essential in ocular system function, as lids and tears . Nowadays we know that reciprocal relations between this items are essential in ocular surface homeostasis. Any disruption means the rise of redness, infections, ulcers predisposition, and disruptions in epithelization. Today all this malfunctions are known as Ocular Surface Pathologies rising a new subspeciality. Since new advances in tears physiology allows a rational approach to diagnosis and treatment ,we find useful to list out this disorders and proposing a therapeutic schedule.

Síndrome de Floppy palpebral y su relación con el síndrome de apnea obstructiva del sueño / Floppy eyelid syndrome and its relation with obstructive sleep apnea-hypopnea syndrome

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Ensortijamiento adquirido del cabello. Descripción de dos casos, uno de ellos asociado con triquiasis / Acquired kinking of the scalp hair. A report of two cases, one of them associated with trichiasis

El ensortijamiento adquirido del cabello es un trastorno raro del crecimiento del pelo del cuero cabelludo en el que los pelos afectados se vuelven oscuros y crespos, asemejándose al vello pubiano. Presentamos dos varones adolescentes afectados con esta enfermedad. En uno de ellos el trastorno se asociaba a triquiasis, en la que algunas pestañas crecen en mala dirección hacia la córnea. En ambos casos los estudios con microscopia óptica y electrónica de barrido mostraron idénticos resultados, con pelos de grosor variable que mostraban secciones más gruesas que alternaban con otras adelgazadas, formaciones canaliculares parciales y rotaciones de 180° sobre su eje longitudinal. Se sugiere que quizá algunos traumatismos mínimos puedan posiblemente actuar en algunos pelos predispuestos, originando el ensortijamiento del cabello en forma similar a la observada en algunos casos de pili torti secundario localizado adquirido (AU)

Corrección de ptosis palpebral congénita con anestesia local en pacientes pediátricos / Congenital palpebral ptosis correción under local anesthesia in pediatric subjects

El presente es un estudio descriptivo basado en experiencia clínica acerca de la corrección de ptosis palpebral en pacientes pediátricos bajo anestesia local, seleccionados según criterios de inclusión específicos, cuyo objetivo es demostrar que este procedimiento, es técnicamente factible, a fin de valorar dinámicamente el grado de correción quirúrgica durante el transoperatorio. Los pacientes se someten a dos fases evaluatorias según su cooperación, tranquilidad y comprensión, las cuales son valoradas por el cirujano y el anestesiólogo a fin de obtener resultados óptimos. El estudio incluyó 11 pacientes y 13 procedimientos, siendo la edad promedio de 8 años. Se valoraron diversos parámetros, considerando a la apertura palpebral como el indicador más importante. Los resultados finales se clasificaron según la cosmesis y la simetría palpebral, obteniendo los siguiente resultados: bueno, 7 pacientes (54 por ciento); regular, 5 pacientes (39 por ciento); y malo, 1 paciente (7 por ciento). Se revisó también a un grupo de pacientes sometidos a corrección de ptosis bajo anestesia general en el mismo lapso, a fin de establecer una comparación de nuestros resultados. Nuestro trabajo constituye una alternativa en el manejo quirúrgico de estos pacientes, debido a que permite valorar la función y evita los riesgos de la anestesia general, además de que plantea la posibilidad de realizar estudios más extensos, con el fin de valorar la prevalencia de ptosis residuales con nuestra técnica y compararlos con la técnica bajo anestesia general

Síndrome de flacidez da pálpebra superior / Floppy eyelid syndrome: report of five cases

Säo apresentados cinco casos de "Floppy Eyelid Syndrome", com respectivas descriçöes clínicas e condutas terapêuticas. Faz-se uma ampla revisäo da literatura sobre o assunto e propöe-se o nome de "Síndrome da Flacidez da Pálpebra Superior" para ser adotado em nosso meio

Blefaroptose pós-cirurgia de catarata e glaucoma; comparaçäo entre dermatocalase e bolsas palpebrais como fator de risco / Blefaroptosis after cataract and glaucoma surgery comparison between dermatochalasis and baggy lids as a risk factor

Os autores apresentam um estudo comparativo entre pacientes de um grupo controle, de um grupo portador de dermatocalase e outro grupo portador de bolsas gordurosas palpebrais. Concluem ser mais provável a ocorrência de ptose palpebral pós-retopexia no pós-operatório de cirurgia de catarata ou glaucoma em pacientes que apresentam bolsas gordurosas palpebrais prévias à cirurgia. (P<0,05)

Síndrome de Perry Romberg com comprometimento palpebral precoce / Parry Romberg´s Syndrome with early palpebral compromising

O autor relata um caso de síndrome Parry Romberg com atrofia hemifacial, em um paciente, sexo masculino, de 34 anos, branco, natural de Alegrete, RS, com comprometimento ocular devido a dificuldade do fechamento palpebral.