Archives of Ophthalmology

Patrinely, James R.;Anderson, Richard L.

doi: 10.1001/archopht.1986.01050230145051pmid: 3778292

Abstract • We present a modification of the frontalis suspension for blepharoptosis, first described in 1937, that eliminates many of the drawbacks of traditional brow suspension techniques. Functional and cosmetic problems with standard suspension procedures are related to the superficial location of the sling in the eyelid, which leads to unsatisfactory geometric tenting of the pretarsal and preseptal skin, obliteration of the lid crease, and a pulling away of the upper lid from the globe with brow elevation. Eyelid height is also limited by the upper lid being pulled away from the globe. By anchoring the suspensory material behind the superior orbital septum near the arcus marginalis, more physiologic vectors of elevation are transmitted to the upper eyelid. This modification has yielded good cosmetic and functional results in 96 cases of frontalis suspension using both autogenous and alloplastic materials, and it deserves to be more widely used. References 1. Anderson RL, Beard C: The levator aponeurosis: Attachments and their clinical significance . Arch Ophthalmol 1977;95:1437-1441.Crossref 2. Anderson RL, Dixon RS: Aponeurotic ptosis surgery . Arch Ophthalmol 1979;97:1123-1128.Crossref 3. Anderson RL, Dixon RS: The role of Whitnall's ligament in ptosis surgery . Arch Ophthalmol 1979;97:705-707.Crossref 4. Doxanas MT, Anderson RL: Clinical Orbital Anatomy . Baltimore, Williams & Wilkins, 1979, pp 76-77. 5. Hildreth HR: Ox-fascia-transplant operation for ptosis . South Med J 1937;30:471-473.Crossref 6. Hildreth HR, Silver B: Physiologic approach to frontalis lid suspension . Ophthalmology 1970;74;427-428. 7. Crawford JS: Use of fascia lata in the correction of ptosis , in Bosniak SL (ed): Advances in Ophthalmic Plastic and Reconstructive Surgery . New York, Pergamon Press, 1982, pp 221-236. 8. Beard C: Ptosis. St Louis, CV Mosby Co, 1981, pp 169-171. 9. Smith B, Bosniak SL: Frontalis sling complications . Ophthalmic Surg 1980;11:614-616. 10. Iliff WJ: Ptosis surgery , in Duane TD, Jaeger EA (eds): Clinical Ophthalmology . New York, Harper & Row Publishers Inc, 1985, vol 5, pp 1-15.

Tolentino, Felipe I.;Baehr, Edward F.;Miyamoto, Keifuku

doi: 10.1001/archopht.1986.01050230149052pmid: 3778293

Abstract • We have designed a new instrument that dissects and cuts complex vitreoretinal membranes. It is a modified hook with a wedge-shaped front end. An anvil-like platform serves as a "chopping block." An oscillating knife, housed in the hollow shaft of the hook, is driven against the anvil to cut the membrane. The instrument is powered by compressed air and controlled by a multifunctional, portable console and universal pedal. We evaluated the system in 125 cases of complicated retinal detachment and found it to be effective, safe, reliable, and durable. The console and pedal can also serve to activate other instruments used in all intraocular microsurgical procedures, including vitrectomy and cataract surgery, and to interface with diathermy, cryosurgery, endolaser, and phacofragmentation machines. References 1. Machemer R, Parel JM, Hickingbotham D, et al: Membrane peeler cutter: Automated vitreous scissors and hooked needle . Arch Ophthalmol 1981;99:152-153.Crossref 2. Charles S, Wang C: Pneumatic intraocular microscissors . Arch Ophthalmol 1981;99:1251.Crossref 3. Michels R: Vitreous Surgery . St Louis, CV Mosby Co, 1981, p 440. 4. Stern WH, Willens R: Integration of vitreoretinal instrumentation . Am J Ophthalmol 1985;100:856-857. 5. Michels RG, Stark WJ: Vitrectomy technique in anterior segment surgery: Symposium: Pars plana vitrectomy . Ophthalmology 1976; 81:382-393.

doi: 10.1001/archopht.1986.01050230154053pmid: N/A

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