• Archives of Craniofacial Surgery
• /
• v.20 no.1
• /
• pp.3-9
• /
• 2019

Facial nerve palsy has an effect on a person's well-being functionally and psychologically. Therefore, comprehensive patient management is essential. One of the most common uncomfortable and potentially debilitating features is associated with the incapacity for eye closure. Restoration of eye closure is a key consideration during the surgical management of facial palsy. In this article, we introduce simple surgical methods-which are relatively easy to learn and involve the upper and lower eyelids-for achieving eye closure. Correcting upper eyelid function involves facilitating the component of eye closure that is in the same direction as gravity and is, therefore, less complicated and favorable outcomes than correction of lower lid. Aesthetic aspects should be considered to correct the asymmetry caused by facial palsy. Lower eyelid function involves a force that opposes gravity for eye closure, which makes correction of lower eyelid ectropion more challenging than surgery for the upper eyelid, particularly in terms of effecting a sustained correction. Initially, proper ophthalmic evaluation is required, including identifying the chronicity and severity of ectropion. Also, it is important to determine whether or not lateral canthoplasty is necessary. The lateral tarsal strip procedure is commonly used for lower lid correction. However, effective lower lid correction can be achieved with better cosmesis when extensive supporting techniques are applied, including those involving cheek tissue.

• Archives of Plastic Surgery
• /
• v.32 no.3
• /
• pp.299-303
• /
• 2005

The epicanthal fold is common natural finding in Asian eyes. It is very common that patients, who look for oriental blephaloplasty for double eye lid, request correction epicanthal fold. It is very often difficult to achieve satisfactory results if the correction of the epicanthal fold is not corrected concomitantly. Many authors described surgical procedures for correction of epicanthal folds. But most of them leave additional scars which tend to be hypertrophic and noriceable. We achieved satisfactory result in epicanthoplasty with invisible scar, using combination of procedures, such as upward incision, double eyelid operation, anchoring suture of the medial upper lid skin to the medial canthal tendon, trans-nasal root subcutaneous mattress suture of the epicanthal fold itself and combined rhinoplasty. For past six years (1998 to 2003) 17 patients have been operated with one of these mentioned procedures. The mean follow up was 4months (2weeks to 6months). All patients were satisfied and no major complication was noted. This method can be one of the effective procedures for correcting the Asian epicanthal fold for avoiding potential visible scar and ancillary procedure in double eye lid blephaloplasty.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.14 no.3
• /
• pp.201-206
• /
• 1992

The eyelids perform many complex functions and are esthetically important, since eye is focal point of face. Tumor extirpation or trauma can lead to full-thickness eyelid defect, which Should be reconstructed as soon as possible There are a number of operation methods for lower lid reconstruction, and among them, Hughes procedure is a time-honored method. Its advantages are good cosmetic result and conjunctival repair by using eyelid structures to rebuild eyelid structures. However, this is a two-staged procedure in which the vision of the affected eye is obstructed during the interval between the operations. We experienced a case of trauma-induced full-thickness lower lid defect extending over one-third of lid length treated by Hughes method. The cosmetic and functional result was good and there was no donor site morbidity, and now we report this case with review of literatures.

• Journal of Korean Ophthalmic Optics Society
• /
• v.9 no.1
• /
• pp.145-159
• /
• 2004

A mathematical model and its computer solution program were proposed to analyze the motion of contact lenses which are being subject to lid-blinking. The equation was derived by incorporating an acceleration induced lid's force exerting on the contact lens, the viscous damping resistance in the tear layer beneath the lens and the sliding frictional force between the lid and the contact lens surface into the formulation of differential equation describing the vibration. The model predicts the time-dependent displacement from the equilibrium postion during/after the blinking. During the blinking, as the time for the completion of one cycle of blinking decreases the off-the-equilibrium displacement of contact lens increases while the decrease of diameter in the contact cause the opposite effect. It is found that lid pressure exerting on the lens cause an insignificant lens displacement from the equilibrium position. After blinking the frequency of damped oscillation of contact lens decreases as the diameter of lens increases, due to the incresed surface while the reduced blinking time does not cause a significant frequency change. This is because that driving force for the contact lens movement posterior to blinking is the capillary-induced force not the lid force.

• Annals of Clinical Neurophysiology
• /
• v.4 no.1
• /
• pp.63-66
• /
• 2002

Blepharospasm and apraxia of lid opening(ALO) are non-paralytic causes of involuntary eyelid closure. Clinically it is difficult to differentiate blepharospasm and ALO, and these two conditions are sometimes associated. We report a case of pretarsal blepharospasm presenting as apraxia of lid opening. 55-year-old woman was noted to have voluntary eye opening difficulty. We synchronously record the electromyographic(EMG) from the levator palpebrae superioris and the orbicularis oculi muscles in this patient. This results suggested that she has a variant of blepharospasm due to abnormal contraction in the pretarsal orbicularis oculi.

• Archives of Plastic Surgery
• /
• v.32 no.3
• /
• pp.304-310
• /
• 2005

Bulging of the lower eyelid & tear trough groove is regarded as a sign of aging. In the past, the surgical excision of the fat pad has been the mainstray of the management of lower palpebral bag in cosmetic blepharoplasty, Recently, fat pad sliding method has been introduced to make more attractive lower eyelids. We used the fat pad for covering the hollowness of the lower eye lid. And we use redundant fat pad for filling & augmentation of the lower eye lid by reflexion. Redraping of the orbicularis arc, with its accompanying midfacial fat repositioning, anatomically restores the cheek and lower lid to make more youthful contour. By redraping and fixing the orbicularis arc on the medial surface of the orbital rim, it becomes a more attractive midface and may prevent of ectropion. From August, 2002 to July, 2004 in correction of lower palpebral bulge & tear trough groove, these two technique were performed in 42 consecutive individuals (84 lower eyelid) for two-year period. Follow up ranged from 3 to 15 months. (an average of 9 months) Palpebral bulge & tear trough groove were corrected and obtained a youthful midface. Complication was rare. The advantages of these techniques are that: prevent in of secondary palpebral bulge and irregularity of lower eyelid by using of reflexed fat fad; prevent in of ectropion. Thus an attractive midface is obtained by redraping of orbicularis arc.

• Archives of Plastic Surgery
• /
• v.33 no.4
• /
• pp.499-502
• /
• 2006

Purpose: Grave's disease is an autoimmune disease with chronic and systemic features. It affects the orbital fat and muscle bringing about defect in extrinsic eye motility, diplopia, optic nerve defect and lid retraction. In patients with lagopthalmos and resulting facial deformity, treatment can be done by rectus muscle recession or filling with various material. Autogenous auricular cartilage graft is often used and synthetic material such as synthetic acellular dermis, polyethylene meshs are also used for filling of the depressed area. Nevertheless, autogenous auricular cartilage grafts are difficult to utilize and synthetic materials sometimes result in protrusion or infection. Therefore, hard palate mucosa was considered as an alternative. We report two cases of patients with lower eyelid retraction corrected with autogenous hard palate mucosa. Methods: We performed this operation in two patients of Graves' ophthalmopathy. The capsulopalpebral fascia was incised and elevated through an incision on the conjunctiva. Then, the harvested hard palate mucosa was sutured to the inferior border of the tarsus and covered with the conjunctiva. Results: The lower eyelid retraction was corrected successfully. No hypertrophy or deformation of the transplanted hard palate mucosa was noted 6 months after the surgery. Conclusions: From the results above, we may conclude that the hard palate mucosa serves as an ideal spacer for the curvature and the inner lining in lower lid retraction. Hard palate mucosa is as sturdy as the autogenous cartilage but is much easier to utilize. It can be also used for lid retraction after lower lid aesthetic surgeries or traumas.

• Journal of Korean Ophthalmic Optics Society
• /
• v.13 no.2
• /
• pp.9-16
• /
• 2008

To assess the preference and efficacy of empirical fitting methods with spheric and aspheric RGP lenses. Methods: Healthy 37 subjects were fitted with spheric design (diameter 9.3 mm) on right eye and aspheric design (dia 9.6 mm) on the left eye. Base curves which were fitted empirically (using on-K, Kavg-0.50D (or 1.00D) and manufacturer's recommended fitting guide) were compared with another base curve which obtained the best diagnostic fit with spheric and aspheric RGP lenses. The preference and fitting type (lid attachment or interpalpebral) for two design lenses were investigated 2 weeks after fitting RGP lenses. Results: Of 33 successful RGP lens-wearing subjects, 76% preferred spheric design compared with 24% of aspheric RGP lens wearers. Sixty seven percent were fitted with lid-attachment in spheric lenses, whereas 64% were fitted with lid-attachment in aspheric lenses. The acceptable fit success rates within ${\pm}$0.50D of base curves were 97% for the on-K fit, 100% for the Kavg-0.50D fit and 100% of the manufacturer's guide fit compared with the diagnostic fit in spheric design, whereas 91%, 79% and 94% reported on-K, Kavg-1.00D and manufacturer's guide, respectively, in aspheric design. Conclusions: Although aspheric RGP lenses are more popular in the Korean market, it is still preferable to fit subjects with spheric RGP lenses. Empirical fitting may be best accomplished with the spheric lenses using Kavg-0.50D fit and the manufacturer's fitting guide, whereas aspheric RGP lens designs are unacceptable lens fit based on empirical fitting.

• The Korean Journal of Nuclear Medicine
• /
• v.3 no.1
• /
• pp.41-49
• /
• 1969

742 cases of thyroid diseases treated at Radio-isotope Clinic, Seoul National University Hospital since October 1965 through July 1968 were analyzed. The patients were classified according to eye findings, as to Infiltrative, Non-infiltrative and No ophthalmopathy. Correlations between ophthalmological findings and symptoms, BMR values and $^{131}I$ uptake rate as well as response to medical treatment were carefully reviewed. Results obtained were as follows: 1. Among goitrous patients 44.5% with infiltrative ophthalmopathy, 24.1% with non-infiltrative ophthalmopathy totaling 68.6% of patients with one or more eye findings were found. Exophthalmos (44%) and visual disturbances (44%) comprised the highest incidence among eye signs. Most frequent eye symptoms were lid swelling (17.1%). 2. Female patients were predominant(91%). 3. Of cases with hyperthyroidism, after treatment with antithyroid drugs and radio-iodine therapy, general symptoms were improved in over 74%, whereas ophthalmopathy was not changed and in some cases the eye signs were aggravated. This tendency was more apparent in infiltrative ophthalmopathy. 4. Significant correlations between exophthalmos, BMR values and $^{131}I$ uptake rate were found. Among the patients of same degree of exophthalmos, BMR values and $^{131}I$ uptake rate showed the highest in non-infiltrative ophthalmopathy, moderate in infiltrative ophthalmopathy and the lowest in no ophthalmopathy.

• Journal of Korean Ophthalmic Optics Society
• /
• v.6 no.2
• /
• pp.161-164
• /
• 2001

The purpose of our study was stability of tear film for Korean. In the 1970s, the major problem for the contact lens practitioner was the management of contact lens parameters. In the 1980s, oxygen permeability was the main problem in contact lens practice: now it is dry eyes. To appropriately fit the patient with contact lenses it is imperative to know in advance if the patient has a marginal dry eye. Based on the initial diagnosis appropriate care can be taken to minimize problems with the result that the patient can successfully wear contact lenses. A well known test for dry eyes is Schirmer test which has shown to be useful for diagnosing Sjogren syndrome. Biomicroscopy can often unmask numerous problems. The classical test for marginal dry eye is measuring the tear break up time(TBUT). A dry eye problem with contact lenses is often caused by the lid. If an incomplete blink is responsible for the dry eye it is possible to change the situation by blinking exercises. The result of these test, mean value of age was 22.8, mean value of blink rate was 19 times/min, mean value of Schirmer test was 25 mm/5 min, mean value of TBUT was 7.1 sec.