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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)
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)
Lower eyelid retraction associated with prior blepharoplasty, trauma, or other conditions is a challenging problem for the ophthalmic surgeon. We describe a procedure involving tightening the lower eyelid and supraplacing the lateral canthus in combination with in-glove lysis of the lower eyelid retractors and scar tissue. This is accomplished through a(More)
OBJECTIVE The authors evaluated a new design of a conical-shaped enucleation implant to help minimize the occurrence of superior sulcus defects and maximize motility of the prosthesis. The implant shape is a modification of a sphere. It has a posterior conical projection paralleling the orbital walls, a superior projection supporting the soft tissues of the(More)
The purpose to this study was to determine whether early surgical repair is indicated for a severely entrapped inferior rectus muscle following orbital blowout fracture. We report two patients with small blowout fractures, severe entrapment of the inferior rectus muscle, and an absence of the inferior rectus muscle in multiple contiguous coronal computed(More)
The paralytic properties of botulinum A toxin have led to its use in humans in the treatment of strabismus and facial dystonias such as essential blepharospasm. Examination of orbicularis muscle from 10 patients with essential blepharospasm who received 2-18 injections of botulinum toxin 6 weeks to 3 years prior to surgery revealed characteristic nodal,(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)
PURPOSE Patients presenting with blepharoptosis due to disinsertion or thinning of the levator aponeurosis require surgical repair. A minimally invasive approach directed specifically at the levator aponeurotic anatomic defect may provide benefits to the patient. Proposed advantages of a small eyelid incision (8-13 mm) include less local anesthetic and(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)