Index

Adenoid cystic carcinoma, 134, 135Angiography, 164Anophthalmos, congenital. See Congenital

clinical anophthalmosAzithroprine, 58

Bacterial canaliculitis, 70Beta-blockers, 169Blepharoplasty. See Lower blepharoplasty;

Upper blepharoplastyBreast carcinoma, 54, 55, 178Brow suspension, unilateral ptosis. See also

Levator muscle recessioncompensatory eyebrow elevation, 117–118congenital dystrophic ptosis, 118fascia implantation, 122–123frontalis muscle, innervation patterns, 118harvesting autogenous fascia lata, 121–122levator muscle recession, 119–121materials, 121mechanical principals, 122partial or total levator muscle recession

planning, 118–119surgical technique, 121–123upper lid approach, 122

Canalicular infl ammationanatomy, 67–68bacterial canaliculitis, 70chemotherapeutic agents, 71–72dacryocystorhinostomy and retrograde

canaliculostomy, 74–75drug eruptions, 71embryology, 67etiology, 67, 68histology, 68iatrogenic causes, 71–73infective causes, 69, 70Jones canalicular bypass tube placement, 75lacrimal stents and plugs, 73lichen planus (LP), 70microbial canaliculitis, 69ocular cicatricial pemphigoid, 70–71pathophysiology, 68–69physiology, 68radiotherapy, 72–73surgical management, 74–75systemic infl ammatory disease, 70–71

topical ophthalmic treatments, 73Carcinoid tumor, 179–180Cavernous hemangioma, 134, 135Collagen fi llers, 216Computed tomography (CT)

bone window CT scan, 126–127, 128diagrammatic representation, 125–126iodinated intravenous contrast agents, 127, 128orbital and periorbital structures, 126orbital diseases, 126, 127scanners, 127–128

Congenital clinical anophthalmosage, 106associated systemic and ocular diseases, 107–110birth, 107examination, 106family history, 106–107nasolacrimal system fi ndings, 111–112, 114–115neuroradiological fi ndings, 111, 113–114patient data, 106patients, 106pregnancy history, 107systemic diseases, 114unilateral microphthalmos, 113

Conjunctival MALT lymphoma, 3Corticosteroids, 54–55Cosmetic oculofacial plastic surgery

endoscopic brow lift , 23, 25–29facial analysis, 22–25lower blepharoplasty, 33–43upper blepharoplasty, 29–33

Dacryocystorhinostomy, 74–75Dermoid cyst, 134–135, 136Docetaxel (Taxotere), 72

Endoscopic brow lift anesthesia, 26eyebrow elevation, 25–26frontalis contraction, 23, 26postoperative care, 27–29retro orbicularis oculi fat (ROOF) defl ation, 23, 25surgical procedure, 26–27

Esophageal carcinoma, 176Etanercept, 59Eyelid blepharoplasty. See Lower blepharoplasty;

Upper blepharoplasty

232 Index

Facial analysisaging, 22facial layers, 22fat loss, 22, 23workup sheet, 23, 24–25

Fibrous dysplasia, 135, 1365-Fluorouracil (5-FU), 71–72Follicular lymphoma

cytogenesis, 6imaging fi ndings, 8incidence, 2pathogenesis, 3pathology, 5treatment, 11, 12

Hemangioma. See Infantile hemangioma (IH)Hyaluronic acid fi llers, 216Hydroxyapatite (HA) implants. See also Orbital implants

advantages, 196–197vs. aluminum oxide (Bioceramic) implant, 198, 199Bio-Eye, 197complication, 197FCI3 implants, 197vs. porous polyethylene implants, 197

Idiopathic orbital infl ammatory syndrome (IOIS), 57alkylating agents, 58–59anatomic location, 48anatomic site, 49antimetabolites, 58biologic agents, 59corticosteroids, 57–58orbital biopsy, 56diff erential diagnosis, 48, 50management algorithm, 57neoplasm, 53–54, 55orbital cellulites, 50–52pediatric IOIS, 60radiation, 58sarcoidosis, 52sclerosing pseudotumor, 60–61T-cell inhibitors, 59thyroid eye disease (TED), 49–50Tolosa–Hunt syndrome (THS), 62–63Wegener granulomatosis, 52–53

Infantile hemangioma (IH)active nonintervention, 164–165beta-blockers, 169classifi cation, 162clinical phases, 161diff erential diagnosis, 162–163embolization, 168etiology, 161–162histology, 162interferon-alfa, 166–167investigation, 163–164ocular complications, 163pulsed-dye laser (PDL), 167–168steroids, 165–166surgery, 168–169treatment indications, 165vincristine, 167

Infl iximab, 59Injectable soft -tissue fi llers

advantages, 215collagen fi llers, 216complications, 215–216hyaluronic acid fi llers, 216lower eyelid elevation, 226orbit, 217, 219preorbital volume loss (see Preorbital volume loss)semipermanent injectable soft -tissue fi llers, 216–217tear trough, 220–223, 224temple and brow, 223–224types, 216–217upper eyelid and brow, 220, 221volume replacement, 215

Interferon-alfa, 166–167Iodinated intravenous contrast agents, 127, 128

Jones canalicular bypass tube placement, 75

Lacrimal canalicular infl ammation and occlusion. See Canalicular infl ammation

Lacrimal drainage systemDCR, lacrimal sac biopsy, 97–99diagnosis, 95, 96lacrimal sac lesions, 99–103lacrimal sac tumors, 95, 96lesions, treatment and prognosis, 99–103malignant melanoma, 100, 101oncocytoma, 100, 102primary non-Hodgkin B-cell lymphoma (MALT),

99, 100pyogenic granuloma, 101, 102sarcoidosis, 101, 103squamous cell carcinoma, 99, 100surgical anatomy, 96–97Wegener granulomatosis, 101, 103

Lacrimal stents and plugs, 73Levator muscle recession

approach, 119eyelid level evolution, 121partial levator recession, 119, 120principle, 119total levator muscle recession, 119, 121undercorrection and overcorrection, 121

Lichen planus (LP), 70Lower blepharoplasty

fat protrusion and infraorbital hollowness, 35–36fat removal vs. fat preservation, 36–37inferior orbital rim and bony midface, 36, 37infralash muscle plication blepharoplasty, 38, 39lid retraction and ectropion, 35lower eyelid and midface, 33, 34lower eyelid fi llers, 39–41, 42midface implants, 41, 42–43midface retrusion, 36, 37skin excess, 33, 35transconjunctival blepharoplasty, 35, 36transconjunctival fat repositioning, 38–40

Lung carcinoma, 178–179Lymphangioma, 136, 137Lymphoma, 136, 137

Index 233

Magnetic resonance imaging (MRI)components, 129image creation, 131–134Larmor frequency, 129–130spinning tops, 129, 130T1 constant, 130–131T2 constant, 132, 133

Malignant peripheral nerve sheath tumors, 81Malignant schwannomas. See Malignant peripheral

nerve sheath tumorsMantle cell lymphoma

clinical features, 7cytogenesis, 6, 7histology, 4–6

Melanoma, 100, 101, 179Metastatic orbital tumors

biopsy, 177–178breast carcinoma, 178carcinoid tumor, 179–180chemotherapy, 180clinical features, 175–176diff erential diagnosis, 180epidemiology, 173–174hormonal therapy, 180–181imaging and patterns, 176–177lateralization, 174localization, 174–175lung carcinoma, 178–179melanoma, 179metastasis, biological behavior and timing, 174prognosis and survival, 181prostatic cancer, 179radiotherapy, 180surgery, 181

Methicillin-resistant Staphylococcal aureus (MRSA) infection, 153–154

Methotrexate, 58Microbial canaliculitis, 69Mitomycin C therapy, 73Mucosa-associated lymphoid tissue (MALT)

chronic antigen stimulation, 3clinical features, 7imaging fi ndings, 8lymphoepithelial unit, 4pathology, 4PET scan, 10, 11radiotherapy, 12

Myositis, 136, 138

Neurofi bromas, 80–81Neurofi bromatosis type 1 (NF1). See also Orbitofacial

neurofi bromatosis type 1 (NF1)clinical manifestations, 79–80diagnostic criteria, 80genetics, 83malignant peripheral nerve sheath tumors, 81medical management, 84neurofi bromas, 80–81nomenclature, 79optic pathway gliomas, 81–82surgical management, 84–90

Nonporous spherical implants, 199–200Non-surgical volume enhancement. See Injectable

soft -tissue fi llers

Ocular adnexal lymphoproliferative disease (OALD)chemotherapy, 12chronic antigen stimulation, 3classifi cation, 2clinical features, 7cluster of diff erentiation (CD), 2cytogenetics, 4–6, 7follicular lymphoma, 11imaging fi ndings, 8, 9immunosuppression, 3–4immunotherapy, 12–13incidence, 1mantle cell lymphoma, 11outcome, 13pathogenesis, 2–3pathology, 4–6positron emission tomography, 9radioimmunotherapy, 13radiotherapy, 11–12staging, 9treatment, 9–11

Ocular cicatricial pemphigoid, 70–71Oncocytoma, 100, 102Optic pathway gliomas (OPGs)

anterior approach, 88blind proptotic left eye, 81imaging and chemotherapy, 82lateral approach, 87orbital imaging, 138progression, 82proptosis, surgical intervention, 87–88remission, 82superior approach, 88

Orbital and periorbital malignanciescetuximab, 191–192imatinib mesylate, 190–191rituximab, 188–189yttrium-90-labeled ibritumomab tiuxetan, 189–190

Orbital cellulitis, 50–52evaluation, 154–155medical therapy, 155–156prevention, orbital fracture, 158surgical treatment, 156–158

Orbital imagingadenoid cystic carcinoma, 134, 135cavernous hemangioma, 134, 135computed tomography (CT) (see Computed

tomography (CT))dermoid cyst, 134–135, 136diff usion MRI (diff usion-weighted imaging), 140–141fi brous dysplasia, 135, 136lymphangioma, 136, 137lymphoma, 136, 137magnetic resonance imaging (see Magnetic

resonance imaging (MRI))myositis, 136, 138optic nerve gliomas, 138positron emission tomography, 141–142

234 Index

pseudotumor, 139rhabdomyosarcoma, 139three-dimensional images, 129ultrasound (echography) (see Ultrasound (echography))

Orbital implants. See also Hydroxyapatite (HA) implantsadults, 199–200children, 200–201extraocular muscle attachment, 202–203implant wrapping, 202peg and sleeve implants (see Peg and sleeve

implant–prosthesis coupling systems)porous orbital implants, 197–199 (see also Porous

orbital implants)volume considerations, 201wrapping materials (see Wrapping materials)

Orbital volume loss. See also Injectable soft -tissue fi llersetiology, 213, 214features, 214–215

Orbitofacial neurofi bromatosis type 1 (NF1). See also Optic pathway gliomas (OPGs)

malignant peripheral nerve sheath tumors, 81neurofi bromas, 80–81optic pathway gliomas, 81–82orbital involvement, 86–90periorbital involvement, 85progression, 90–92surgery timing, 84–85surgical management, 84–90

Parry–Romberg syndrome, 220Pediatric IOIS, 60Peg and sleeve implant–prosthesis coupling systems

FCI peg–sleeve coupling system, 205fi brovascularization, 205MEDPOR Motility Coupling Post (MCP), 205polycarbonate peg, 205titanium peg systems, 205

Periocular herpes simplex infection, 69Periorbital cellulitis

CA-MRSA vs. hospital-acquired MRSA, 152–153etiology, 151infection, 149–150microbiology, 151–152orbital MRSA, 153–154pathogens and resistance, 152–154symptomatology and presentation, 149–150

PHACE syndrome, 162, 163Plexiform neurofi broma

malignant peripheral nerve sheath tumors, 80upper eyelid, 80–81

Porous orbital implantsaluminum oxide, 198–199bio-eye implant, 197FCI3 implants, 197fi brovascular ingrowth, 196–197polyethylene implants (MEDPOR), 197–198

Porous spheres, 199Pre-and postoperative internal ptosis repair, 33Preorbital volume loss

cicatricial ectropion, 226etiology, 213–214

features, 215injectable soft -tissue fi llers, 225–226lower eyelid elevation, 226upper eyelid loading, 226volume enhancement, 225

Preservative-related chronic conjunctivitis, 73Primary non-Hodgkin B-cell lymphoma (MALT), 99, 100Proptosis

anterior approach, 88lateral approach, 87superior approach, 88

Prostatic cancer, 179Pseudotumor, 139Pulsed-dye laser (PDL), 167–168Pyogenic granuloma, 101, 102

Quasi-integrated implant, 199

Retro orbicularis oculi fat (ROOF) defl ation, 23, 25, 26Rhabdomyosarcoma, 139Rituximab

B-cell lymphomas, 189CD20, 188–189cyclophosphamide, adriamycin, vincristine, and

prednisone (CHOP), 189

Sarcoidosis, 52, 54, 101, 103Sclerosing pseudotumor, 60–61Semipermanent injectable soft -tissue fi llers, 216–217Soft -tissue fi llers. See Injectable soft -tissue fi llersSPRED1 mutation, 83Squamous cell carcinoma, 63, 99, 100Steroids

intralesional corticosteroid injection, 165–166oral corticotherapy, 166topical steroid, 165

Stevens–Johnson syndrome (SJS), 71

T-cell inhibitors, 59Th yroid eye disease (TED), 49–50Tolosa–Hunt syndrome (THS), 62–63Typical idiopathic orbital infl ammatory

syndrome (IOIS), 57

Ultrasound (echography)extraocular muscle, 145kinetic echography, 143, 145optic nerves, 146quantitative echography, 143topographic echography, 143–146

Unilateral ptosis, brow suspensioncompensatory eyebrow elevation, 117–118congenital dystrophic ptosis, 118frontalis muscle, innervation patterns, 118levator muscle recession, 119–121partial or total levator muscle recession planning,

118–119surgical technique, 121–123

Index 235

Upper blepharoplastyanesthesia, 30brow volumizing, 30–32crease formation, 30, 31excess lateral skin, management, 30, 32marking, 30patient evaluation, 29–30pre- and postoperative internal ptosis repair, 31, 33skin/muscle excision, 30

Wegener granulomatosis, 52–54, 101, 103Wrapping materials

human donor sclera, 203microporous expanded polytetrafl uoroethylene

(e-PTFE), 203polyester-urethane like e-PTFE, 203–204polyglactin 910 mesh, 204vicryl mesh-wrapped implants, 204