John Bryan Holds

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BACKGROUND Orbital emphysema is usually a benign, transient phenomenon. Rarely, the intraorbital air mass can cause central retinal artery occlusion. Because of the potential for severe visual loss, the rapid diagnosis and management of this condition are essential. Currently, there is no standard protocol for the treatment and management of severe orbital(More)
Protection of the eye is the primary concern in managing the patient with facial paralysis; however, the aesthetic consequences cannot be overlooked. Lagophthalmos has traditionally been treated with frequent ocular lubrication, medical eye care, and tarsorrhaphy. This approach is fraught with the difficulties of poor patient compliance and unacceptable(More)
To assess longstanding alterations in human muscle innervation induced by botulinum toxin, we studied motor axons in the orbicularis oculi of nine patients previously injected with botulinum toxin for treatment of benign essential blepharospasm (BEB). Compared with untreated BEB and normal orbicularis oculi, muscle exposed to botulinum toxin developed(More)
PURPOSE To describe a novel surgical technique for lower eyelid blepharoplasty with fat repositioning in an intrasuborbicularis oculi fat (intra-SOOF) plane. METHODS Description of surgical technique and outcome of a retrospective, interventional case series of 66 consecutive patients who underwent surgery. RESULTS Sixty-six patients with an average age(More)
To investigate causes, associations, and results of treatment with blepharospasm, 1,653 patients were evaluated by extensive questionnaires to study blepharospasm and long-term results of treatment with the full myectomy operation, botulinum-A toxin, drug therapy, and help from the Benign Essential Blepharospasm Research Foundation (BEBRF). The percent of(More)
In essential blepharospasm histopathologic and electrophysiologic evidence supports the existence of lesions in proximity to brainstem nuclei controlling ocular movements. We studied horizontal ocular movements in eight patients who had been treated previously with surgery or botulinum toxin injection to control essential blepharospasm (mean age, 58 years)(More)
PURPOSE To describe the spectrum and treatment of orbital Rosai-Dorfman disease and to review previously documented cases. METHODS Retrospective, interventional case series of seven patients and literature review. RESULTS Each patient with Rosai-Dorfman disease had unique disease expression requiring aggressive therapy, such as chemotherapy, radiation,(More)
OBJECTIVE To review the intraoperative and postoperative complications of the transconjunctival approach, as well as their prevention, management, and outcomes. DESIGN A retrospective study of the complications in 400 patients who underwent the transconjunctival approach to the lower eyelid or orbit for treatment of orbital trauma or the aging face. (More)
PURPOSE OF REVIEW The surgical correction of blepharoptosis, both congenital and acquired, has been intensively examined and reported on for many years. This paper reviews recent publications on basic science, evaluation, technique modifications, and innovative materials in the care of ptosis patients. RECENT FINDINGS The frontalis suspension technique is(More)
PURPOSE To determine the outcome and safety of pediatric endonasal dacryocystorhinostomy with the use of adjunctive mitomycin C. METHODS A prospective, nonrandomized and noncomparative interventional case series study was performed in 71 consecutive procedures. Sixty patients 16 years of age and younger underwent nonlaser endonasal dacryocystorhinostomy(More)