Breaking News Related to Macular Degeneration, Cataract, Glaucoma, Corneal Disease and Other Eye Conditions » Plastics

Eyebrow Fat Not Getting “Respect”

Dr. Ari Weitzner — Thu, 26 Apr 2012 09:39:17 +0000

Archives: researchers, using sophisticated 3D CT scanning, have demonstrated that eyebrow fat increases in volume in thyroid eye disease, just like the fat and soft tissue in the orbit. They suggest that eyebrow fat be examined more carefully and that standards and normals be established, so that eyebrow fat can be better addressed when surgical correction of thyroid eye disease is considered. Typically it is ignored as surgeons focus on the retrobulbar and orbital tissue that causes disfiguring exophthalmos (bulging out) of the eyeballs.

Amniotic Membrane Effective in Stevens-Johnson Syndrome

Dr. Ari Weitzner — Tue, 24 May 2011 09:52:54 +0000

Ophthalmology: Stevens-Johnson syndrome is an awful, devastating disease where skin and mucus membranes go haywire and blister and fall off. It is a weird and rare reaction to certain medications like sulfa. Blindness is not uncommon as the eye membranes are destroyed and the eye utterly dries up. Researchers have been very successful in quickly applying amniotic membranes to all the lid and eye surfaces, allowing good healing with excellent vision of 20/20 in 9/10 patients. This really ought to be the standard of care.

Silicone Vs. Fascia Lata For Ptosis- Where Do You Fit?

Dr. Ari Weitzner — Wed, 11 May 2011 16:08:16 +0000

Surgeons debated the pros and cons of autogenous fascia lata and silicone as a suspension material for congenital ptosis. Fascia lata was noted to have less infection and granuloma rates and more staying power. Silicone, of course, is a shorter operation and leaves no scars on the leg- an important consideration especially for women. It also is easier to adjust if necessary.

Does SmartPlug Treatment for Dry Eye Pose an Infection Risk?

Dr. Ari Weitzner — Wed, 06 Apr 2011 10:26:20 +0000

An article in Review of Ophthalmology reports potential problems with the SmartPlug treatment for dry eye from Medennium. Dr Fezza noted a high incidence of canaliculitis among those who received this plug in his practice. The plugs are typically inserted inside the canaliculus as a treatment for dry eye. Some patients required surgical procedures to remove the plug and associated inflammatory masses and stones. Reportedly, the company did not respond to the editor’s request for information.

Click here to read the full article.

Are Gold Weight Implants Helpful in Treating Blink Lagophthalmos and Dry Eye Keratopathy?

Dr. Ari Weitzner — Fri, 14 Jan 2011 07:50:34 +0000

Ophthalmology: Many patients, even in the absence of Bell’s palsy, have lagophthalmos with blink, and a low blink rate, which can cause significant discomfort and damage to the cornea as in exposure keratopathy. Researchers found that placing a gold weight in the upper lid was very helpful in improving signs and symptoms.

Click here to view the abstract.

Can Topical Imiquimod Be Used to Treat Periocular Lentigo Maligna?

Dr. Ari Weitzner — Tue, 28 Dec 2010 22:33:08 +0000

From the latest issue of Ophthalmology comes the results of a study intended to evaluate the efficacy of topical imiquimod 5%, a local immune response modifier, in the treatment of periocular lentigo maligna, often a pre-malignant pigmentary process that looks like a large, bad freckle.

The results show that periocular lentigo maligna responded beautifully to topical imiquimod (which has also been helpful in treating warts). Nice to be able to treat with a cream instead of surgery.

Topical Timolol Helps Hemangioma

Dr. Ari Weitzner — Sun, 06 Jun 2010 13:10:26 +0000

It has been shown that systemic propranolol can greatly reduce hemangiomas around the eye, thus sparing the baby risky surgery or steroidal injections to debulk it. But systemic propranolol can be a little risky and requires a hospital stay. Researchers recently got similar results rubbing Timolol on the lesion.

Is it Okay to Delay Repair of a Ruptured Globe?

Dr. Ari Weitzner — Wed, 03 Mar 2010 05:38:29 +0000

The Iraq War has taught surgeons a valuable lesson- many soldiers with ruptured globes who, by necessity, were forced to delay surgery sometimes up to 4 weeks, still got good results. Just as in a dropped nucleus, maybe it’s OK or better to wait for the eye to quiet down before operating.

Can Dr. Maskin’s Probe Help Control Meibomian Gland Disease?

Dr. Ari Weitzner — Wed, 12 Aug 2009 00:34:21 +0000

Posterior blepharitis, meibomian gland disease- it has several names, we see it very often, and it’s difficult to control. We typically try antibiotic drops/ointment, steroid drops, hot compresses, lid hygiene, Restasis, flaxseed oil etc. Dr. Maskin has come up with a novel idea of probing each gland with a special probe he developed with Rhein, which clears obstruction of the glands and allows the lipid to drain effectively. He claims his patients get many months of relief, and can be repeated. The probes are now commercially available- may be worth a try

Conjunctivochalasis- underdiagnosed and easy to repair

Dr. Ari Weitzner — Thu, 23 Apr 2009 21:09:17 +0000

Conjunctivochalasis is much more common than we think- we often attribute the symptoms to dry eye and give artificial tears. But ever since I read about this condition some time ago, I see that it is indeed, much more common and symptomatic. I know surgeons will excise the redundant conjunctiva, but I wonder if that’s such a good idea- I have a feeling the patient needs all the conjunctiva they can get for lubrication purposes. I recently saw a video where the surgeon replaces the excised conjunctiva with dry amniotic membrane, glued to the globe- that’s probably a better idea. But I do is the simplest and I think, best- I roatate the eye superiorly and push the conjunctiva down towards the fornix and place about 4-5 8-o Vicryl sutures about 10 mm from the limbus re-attaching it to the globe. That’s it. The sutures create enough irritation to keep the conjunctiva securely on the globe. When I examine the patients later, the conjunctiva is nice and tight on the globe without any redundancy- and I did not sacrifice any conjunctiva. Try it!