Richard D. Lisman, M.D.

Reply: Accidentally Injected Formaldehyde during Cosmetic Blepharoplasty
Lelli, Gary J Jr; Lisman, Richard D
2011 Aug;128(2):587-587, Plastic & reconstructive surgery
— id: 135585, year: 2011, vol: 128, page: 587, stat: Journal Article,

Endoscopic orbital decompression
Zoumalan C.I.; Kazim M.; Lisman R.D.
2011 ;22(3):223-228, Operative techniques in otolaryngology, head & neck surgery
The effectiveness of orbital decompression has been enhanced by the use of endoscopes in orbital decompressive surgery. In patients with severe proptosis and visual compromise, surgical intervention provides definitive therapy. Endoscopes have allowed for more complete removal of the bone posteriorly to the orbital apex under direct visualization, which has led to a decrease in morbidity. Two-wall decompression is now the minimum procedure that successfully achieves release of contents at the orbital apex. Whether the endoscope is used as an adjunct surgically or postoperatively to facilitate debridement, it has become an important tool in the armamentarium for the successful management of proptosis. The endoscopic view of posterior ethmoidal sinuses and the sphenoid sinuses enables the surgeon to successfully carry out a posterior decompression, and provides the opportunity to decompress the optic nerve if the need arises. 2011 Elsevier Inc
— id: 142054, year: 2011, vol: 22, page: 223, stat: Journal Article,

Evaluation of the canalicular entrance into the lacrimal sac: an anatomical study
Zoumalan, Christopher I; Joseph, Jeffrey M; Lelli, Gary J Jr; Segal, Kira L; Adeleye, Amanda; Kazim, Michael; Lisman, Richard D
2011 Jul-Aug;27(4):298-303, Ophthalmic plastic & reconstructive surgery
PURPOSE: : The purpose of this study was to investigate the prevalence of a common canalicular entrance in the lacrimal sac and to investigate the anatomy of the canalicular/lacrimal sac junction with direct visualization using a novel cadaveric dissection technique. METHODS: : Preserved cadavers were dissected to allow direct visualization of the canalicular entrance(s) to the lumen of the lacrimal sac. The prevalence of a common canaliculus and the anatomical variations of the canalicular/lacrimal sac mucosal fold of tissue were recorded. RESULTS: : One hundred twenty-four lacrimal systems (95 cadavers; 43 female, 52 male) were included in the study analysis. Overall, 123 lacrimal systems demonstrated a common canaliculus entering the lacrimal sac. Only one demonstrated 2 separate orifices (right orbit; male) in the sac (0.08%; 95% confidence interval, 0.1%-4.4%). Seventy-four lacrimal systems had some variation of a canalicular/lacrimal sac mucosal fold (59.7%). The remaining 50 (40.3%) had no visible canalicular/lacrimal sac mucosal fold. CONCLUSIONS: : This study provides direct anatomical evidence that the prevalence of separate canalicular orifices in the lacrimal sac is lower than previously reported (<1%). Additionally, the presence of a valve-like structure at the canalicular/lacrimal sac junction is common. These observations can potentially play a role in evaluating and treating lacrimal system pathology
— id: 135255, year: 2011, vol: 27, page: 298, stat: Journal Article,

Commentary on: Anthropometry of the Eyelid and Palpebral Fissure in an Indian Population
Zoumalan, Christopher I; Lisman, Richard D
2011 Mar 1;31(3):295-296, Aesthetic surgery journal
— id: 126516, year: 2011, vol: 31, page: 295, stat: Journal Article,

Successful Management of Methicillin-Resistant Staphylococcus aureus Orbital Cellulitis after Blepharoplasty
Juthani, Viral; Zoumalan, Christopher I; Lisman, Richard D; Rizk, Samieh S
2010 Dec;126(6):305e-307e, Plastic & reconstructive surgery
— id: 114864, year: 2010, vol: 126, page: 305e, stat: Journal Article,

Blepharoplasty complications
Lelli, Gary J Jr; Lisman, Richard D
2010 Mar;125(3):1007-1017, Plastic & reconstructive surgery
BACKGROUND:: Postoperative complications of blepharoplasty range from cutaneous changes to vision-threatening emergencies. Some of these can be prevented with careful preoperative evaluation and surgical technique. When complications arise, their significance can be diminished by appropriate management. This article addresses blepharoplasty complications based on the typical postoperative timeframe when they are encountered. METHODS:: The authors conducted a review article of major blepharoplasty complications and their treatment. RESULTS:: Complications within the first postoperative week include corneal abrasions and vision-threatening retrobulbar hemorrhage; the intermediate period (weeks 1 through 6) addresses upper and lower eyelid malpositions, strabismus, corneal exposure, and epiphora; and late complications (>6 weeks) include changes in eyelid height and contour along with asymmetries, scarring, and persistent edema. CONCLUSIONS:: A thorough knowledge of potential complications of blepharoplasty surgery is necessary for the practicing aesthetic surgeon. Within this article, current concepts and relevant treatment strategies are reviewed with the use of the most recent and/or appropriate peer-reviewed literature available
— id: 107788, year: 2010, vol: 125, page: 1007, stat: Journal Article,

Reply
Lelli, Gary J Jr; Lisman, Richard D
2010 Dec;126(6):2277-2278, Plastic & reconstructive surgery
— id: 114870, year: 2010, vol: 126, page: 2277, stat: Journal Article,

Reply
Lelli, Gary J Jr; Zoumalan, Christopher I; Lisman, Richard D
2010 Sep;126(3):1113-1113, Plastic & reconstructive surgery
— id: 112056, year: 2010, vol: 126, page: 1113, stat: Journal Article,

Evaluation and management of unilateral ptosis and avoiding contralateral ptosis
Zoumalan, Christopher I; Lisman, Richard D
2010 May;30(3):320-328, Aesthetic surgery journal
Treating unilateral ptosis can be challenging and a proper preoperative evaluation may help prevent unexpected outcomes on the contralateral lid. Preoperative evaluation should include testing for Hering's law, which remains useful in understanding the phenomenon of induced contralateral eyelid retraction in the context of ptosis. Approximately 10% to 20% of patients with unilateral ptosis have some degree of induced retraction on clinical evaluation in the contralateral lid. When there is a positive Hering's test on preoperative examination, the surgeon should consider a bilateral ptosis procedure. The surgical approach to unilateral ptosis depends on the severity of the ptosis and its etiology, and the surgeon should be aware of which procedure is most likely to provide the best outcome in selected instances
— id: 110693, year: 2010, vol: 30, page: 320, stat: Journal Article,

Balloon canaliculoplasty for acquired canalicular stenosis
Zoumalan, Christopher I; Maher, Elizabeth A; Lelli, Gary J Jr; Lisman, Richard D
2010 Nov-Dec;26(6):459-461, Ophthalmic plastic & reconstructive surgery
PURPOSE:: Canalicular stenosis is a frequent cause of epiphora. Patients with canalicular stenosis often require timely insertion of bicanalicular silicone stents to prevent permanent and complete closure of the canaliculi. This study reports the use of balloon canaliculoplasty in conjunction with silicone tube intubation in selected cases of canalicular stenosis. METHODS:: Patients with canalicular stenosis noted upon probing of the upper and lower lacrimal systems were included in the study. Patients with punctal stenosis underwent concurrent punctoplasty. Patients with complete canalicular obstruction were excluded from the study. The procedure was as follows. Canalicular dilation was achieved with 2 successive dilations of 90 seconds with a 2-mm-diameter balloon dilator, followed by probing and intubation of the lacrimal system with bicanalicular Crawford tubes. RESULTS:: Twenty-one eyes (41 canaliculi) of 12 patients (10 females, 2 males) with canalicular stenosis were included in this study. The average age was 64.5 +/- 7.5 years. Silicone tubes were left in place for an average 5.5 +/- 2.6 (range: 2 to 12) months. Mean follow up after tube removal was 6.2 +/- 1.1 months. Improvement within 1 week of the procedure was recorded in 20 out of 21 canaliculi (95.2%). Final clinical outcomes were successful or acceptable in 16 out of 21 eyes (76.2%). CONCLUSIONS:: Balloon canaliculoplasty with silicone tube intubation is simple and safe and appears to be an effective alternative treatment in patients with canalicular stenosis
— id: 114822, year: 2010, vol: 26, page: 459, stat: Journal Article,

Oculocardiac reflex associated with a large orbital floor fracture
Joseph, Jeffrey M; Rosenberg, Caroline; Zoumalan, Christopher I; Zoumalan, Richard A; White, W Matthew; Lisman, Richard D
2009 Nov-Dec;25(6):496-498, Ophthalmic plastic & reconstructive surgery
A 40-year-old man presented with bradycardia, left eye pain, and intermittent nausea 1 day after blunt trauma to the left orbit. Imaging revealed a large orbital floor fracture with significant herniation of orbital contents but no obvious extraocualar muscle entrapment. Oculocardiac reflex was suspected, and the fracture was repaired surgically within 24 hours of presentation. His bradycardia resolved immediately postoperatively. This case is a unique presentation of the oculocardiac reflex in a large orbital floor fracture with significant herniation of orbital contents but without extraocualar muscle entrapment
— id: 105515, year: 2009, vol: 25, page: 496, stat: Journal Article,

Early postoperative adjustment of the Fasanella-Servat procedure: review of 102 consecutive cases
Rosenberg, Caroline; Lelli, Gary J Jr; Lisman, Richard D
2009 Jan-Feb;25(1):19-22, Ophthalmic plastic & reconstructive surgery
PURPOSE: To describe and evaluate an office-based technique to adjust the Fasanella-Servat procedure in the first postoperative week. METHODS: This retrospective case series reviewed all consecutive eyelids undergoing the Fasanella-Servat procedure between July 1, 2006, and July 1, 2007, by a single surgeon (R.D.L.). Charts were reviewed to determine the frequency, timing, safety, and efficacy of postoperative adjustment. Postadjustment photographs were reviewed by a blinded ophthalmic plastic surgeon for eyelid contour, height, symmetry, overall cosmesis, and picture quality as excellent, satisfactory, or poor. RESULTS: The Fasanella-Servat procedure was performed on a total of 102 eyelids in 54 patients over the 12-month interval. Postoperative adjustments at the time of suture removal were performed to improve mild eyelid asymmetries for 22 eyelids (22%) in 19 patients. Postadjustment photographs, available for 17 patients, showed excellent eyelid contour (53%), height (88%), symmetry (82%), and cosmesis (65%). Satisfactory results were obtained in all remaining photographed eyelids. CONCLUSIONS: The Fasanella-Servat procedure should be viewed as an adjustable ptosis correction with the adjustment as a standard component of postoperative suture removal. This manipulation takes only a few moments with minimal to no patient discomfort. It allows for improvements in eyelid height and contour. This series demonstrates a procedure that is simple, highly successful, and safe
— id: 95884, year: 2009, vol: 25, page: 19, stat: Journal Article,

Subperiosteal orbital fibroma
Charles, Norman C; Lisman, Richard D; Lelli, Gary J Jr
2008 Nov-Dec;39(6):517-518, Ophthalmic surgery, lasers & imaging
A patient noting a slowly enlarging bump at the orbital rim underwent surgical excision of the lesion. Pathologic examination showed a benign fibroma, a lesion that to the authors' knowledge has never been previously reported in this location
— id: 95885, year: 2008, vol: 39, page: 517, stat: Journal Article,

Carcinoma of the lacrimal canaliculus masquerading as canaliculitis
Charles, Norman C; Lisman, Richard D; Mittal, Khushbakhat R
2006 Mar;124(3):414-416, Archives of ophthalmology
— id: 62771, year: 2006, vol: 124, page: 414, stat: Journal Article,

Retrobulbar hemorrhage nine days after cosmetic blepharoplasty resulting in permanent visual loss
Teng, Christopher C; Reddy, Shantan; Wong, Jeffrey J; Lisman, Richard D
2006 Sep-Oct;22(5):388-389, Ophthalmic plastic & reconstructive surgery
A healthy 45-year-old man had a retrobulbar hemorrhage 9 days after cosmetic upper eyelid blepharoplasty that resulted in permanent visual loss. After performing a left lateral canthotomy and cantholysis, intraocular pressure returned to normal and vision improved from no light perception to 20/40; however, the patient did have permanent visual field loss. To our knowledge, this is the longest period of time after blepharoplasty that a retrobulbar hemorrhage occurred. Ophthalmologists should have a heightened level of suspicion 1 to 2 weeks after surgery
— id: 69078, year: 2006, vol: 22, page: 388, stat: Journal Article,

Intraosseous hemangioma of the orbit
Charles, Norman C; Lisman, Richard D
2002 Jul-Aug;33(4):326-328, Ophthalmic surgery & lasers
A case of intraosseous orbital hemangioma is reported to alert surgeons to possible intraoperative hemorrhage during excision of such a lesion. A slowly enlarging mass was excised from the orbital rim of a 49-year-old woman. The clinical diagnosis was not suspected. In retrospect, roentgenographic findings included a focal honeycombed pattern of the zygomatic bone. Surgery was complicated by persistent low-volume bleeding. Histology showed endothelial-lined blood-filled channels within the bone. Intraosseous orbital hemangioma is a rare, benign neoplasm that can often be diagnosed clinically by characteristic roentgenographic findings. Observation should be considered as a therapeutic alternative when the radiographic diagnosis is established and when ocular function is not compromised
— id: 62769, year: 2002, vol: 33, page: 326, stat: Journal Article,

Correlation of unilateral brow elevation and ocular dominance in blepharoptosis
Patel, S; Lisman, R
2001 MAR 15 ;42(4):S339-S339, Investigative ophthalmology & visual science. IOVS
— id: 54973, year: 2001, vol: 42, page: S339, stat: Journal Article,

Concomitant ocular injuries with orbital fractures
Brown MS; Ky W; Lisman RD
1999 Fall;5(3):41-46, Journal of craniomaxillofacial trauma
BACKGROUND AND OBJECTIVES: The orbital floor may fracture alone, and the fracture is then defined as 'pure'; when there is a rim involvement, the fracture may be defined as 'impure'. Controversy exists as to the pathophysiology of orbital floor fractures and the incidence of orbital rim involvement. The purpose of this retrospective review was to determine the incidence of purity in orbital floor blowout fractures and the rate of ocular injuries in pure and impure floor fractures. METHODS AND MATERIALS: The charts of 250 patients with orbital fractures, treated at a primary trauma center between 1992 and 1996, were reviewed. All fractures had been examined by the Ophthalmology Service and confirmed by high-resolution computerized tomography scans. The average age of the patients was 45 years; more than 90% were male. Motor vehicle accidents were the most commonly documented mechanism of injury, followed by interpersonal violence and falls. Almost 50% could not be categorized for mechanism of injury. RESULTS AND/OR CONCLUSIONS: The incidence of ocular injuries in pure fractures (n = 54; 5.6%) was higher than in impure fractures (n = 26; 2.0%) (p = 0.05). Serious visual injuries following orbital fractures occurred in 17.1% of the patients; they were more common in patients with pure fractures
— id: 32665, year: 1999, vol: 5, page: 41, stat: Journal Article,

Prospective analysis of changes in corneal topography after upper eyelid surgery
Brown MS; Siegel IM; Lisman RD
1999 Nov;15(6):378-383, Ophthalmic plastic & reconstructive surgery
PURPOSE: Some patients note a decrease in visual acuity in the operated eye after eyelid surgery. Although, the most common cause for this change is dry eye syndrome, it has been hypothesized that the symptom of blurred vision may result from a change in the corneal curvature. The study was conducted to determine if there is a change in corneal curvature after upper eyelid surgery. METHODS: Standard keratometry and corneal videokeratography (CVK) were performed 1 and 3 months after blepharoplasty (18 lids) and ptosis repair (24 lids). Pre- and postoperative images from CVK data were digitally subtracted for quantitative evaluation. RESULTS: After ptosis repair, the average dioptric change as measured by keratometry and by CVK was approximately 0.60 diopters (D); of note, nearly 30% of these patients showed transient astigmatic changes greater than 1.00 D; After blepharoplasty, the average dioptric change as measured by keratometry and by CVK was approximately 0.55 D; of note, only 11% of patients showed astigmatic changes greater than 1.00 D. CONCLUSION: Repositioning of the upper eyelid after ptosis repair or blepharoplasty may result in visually significant astigmatic changes in the central and peripheral cornea and may alter the patient's spectacle or contact lens correction
— id: 11912, year: 1999, vol: 15, page: 378, stat: Journal Article,

Diplopia following transconjunctival blepharoplasty
Ghabrial R; Lisman RD; Kane MA; Milite J; Richards R
1998 Sep;102(4):1219-1225, Plastic & reconstructive surgery
The resurgence of popularity of the transconjunctival approach to lower eyelid fat removal as a component of cosmetic blepharoplasty has been highlighted by a number of publications in recent years. There has been, however, minimal discussion in the literature of the complications of this procedure. Although the mechanism of muscle injury is similar in transcutaneous and transconjunctival surgery, there is a much more direct route to the inferior extraocular musculature via the latter approach. Herein, we present a series of six patients with diplopia status post-transconjunctival lower eyelid blepharoplasty referred to the Manhattan Eye, Ear, and Throat Hospital for evaluation. Transconjunctival lower lid blepharoplasty was performed as a primary procedure in four patients and as a secondary procedure following transcutaneous blepharoplasty in two patients. Patients were evaluated with ocular examination and orthoptic measurements. Magnetic resonance imaging was obtained in two cases. The inferior rectus and inferior oblique muscles were found to be equally injured in these cases (4 of 6), and the lateral rectus was encountered in one case. Two patients required strabismus surgery to correct their diplopia, whereas four patients improved with observation alone. The possible etiologies of postoperative diplopia following transconjunctival lower lid blepharoplasty are manifold. Mechanisms of extraocular muscle injury may include intramuscular hemorrhage and edema, cicatricial changes within the muscle, and accidental incorporation of extraocular muscle in closure of orbital septum. Avoidance of these complications is probably best achieved through intimate understanding on the part of the surgeon of eyelid anatomy from the transconjunctival perspective
— id: 12075, year: 1998, vol: 102, page: 1219, stat: Journal Article,

Smith's ophthalmic plastic and reconstructive surgery
Levine, Mark R; Lisman, Richard D.; Nesi, Frank A.; Smith, Byron C.
St. Louis, MO : Mosby, c1998,
— id: 696, year: 1998, vol: , page: , stat: ,

Diplopia after surgical repair of orbital floor fractures
Biesman BS; Hornblass A; Lisman R; Kazlas M
1996 Mar;12(1):9-16, Ophthalmic plastic & reconstructive surgery
Blowout fractures of the orbit are common sequelae to blunt facial trauma. Many aspects of this injury have been studied, in particular, the timing of and indications for surgical intervention. Although diplopia is often an indication for surgery and is presented to patients as a potential postoperative complication, the incidence of diplopia after surgical repair of orbital blowout fractures has not been well studied. We retrospectively studied 54 patients who underwent repair of an orbital blowout fracture. A minimum of 6 months follow-up was available for all patients included in the study. A total of 47 of 54 (86%) patients had clinically significant diplopia preoperatively, and 20 of 54 (37%) remained diplopic. A total of 17 of 54 (31%) fractures involved the medial wall and orbital floor, and 13 of these 17 patients (86%) had postoperative diplopia. Patients with combined orbital floor and medial wall fractures appear to be at higher risk for clinically significant diplopia postoperatively than those with fractures of the orbital floor only. The explanation for this observation may be related to a greater difficulty in restoring the preoperative contour of orbits with combined fractures
— id: 24422, year: 1996, vol: 12, page: 9, stat: Journal Article,

Pyogenic granuloma after transconjunctival blepharoplasty: a case report
Soll SM; Lisman RD; Charles NC; Palu RN
1993 Dec;9(4):298-301, Ophthalmic plastic & reconstructive surgery
This is the first known report of a relatively large postoperative pyogenic granuloma developing after a nonsutured transconjunctival blepharoplasty. Inflammation and separation or malapposition of the conjunctival wound edges probably permitted the lesion to proliferate in the inferior fornix. No foreign material could be implicated because no suture was used to close this incision. Additionally, Polydek suture material (braided polyester fiber) was associated with the complication of a suture tract and granuloma when used for a tarsal suspension procedure for ectropion repair in this patient
— id: 35862, year: 1993, vol: 9, page: 298, stat: Journal Article,

Blepharoplasty
Weiner MH; Lisman RD
1993 Nov;4(5):102-107, Current opinion in ophthalmology
Cosmetic blepharoplasty is performed in various subspecialties, therefore articles appear in the ophthalmic, plastic surgical, otolaryngologic, and dermatologic literature. We review the past year's articles regarding evaluation, technique, adjunctive procedures, and complications. As the various techniques of upper-eyelid and lower-eyelid blepharoplasty have taken their place in the armamentarium of the aesthetic surgeon, attention has turned toward adjunctive procedures to enhance the surgical result
— id: 13060, year: 1993, vol: 4, page: 102, stat: Journal Article,

Success of the Fasanella-Servat operation independent of Muller's smooth muscle excision
Buckman G; Jakobiec FA; Hyde K; Lisman RD; Hornblass A; Harrison W
1989 Apr;96(4):413-418, Ophthalmology
In an attempt to elucidate the mechanism whereby the Fasanella-Servat operation corrects ptosis, the authors examined the histopathologic features of 40 consecutive surgical specimens from 37 patients. Because all specimens contained tarsus, this tissue was graded into two groups according to vertical height: (1) minimal (30%) and (2) moderate (70%). Muller's smooth muscle was graded into four groups: (1) absent to negligible (42.5%); (2) minimal (45%); (3) moderate (10%); and (4) large (2.5%). Levator aponeurosis was absent, and conjunctive was present, in all resections. Accessory lacrimal gland tissue was present in 42.5% of cases and did not cause decreased tear production. Although 87.5% of cases had absent to minimal smooth muscle resections, these patients had equally successful results in comparison to patients with moderate to large amounts of smooth muscle resections. Based on these data, the authors have concluded that the effectiveness of the Fasanella-Servat operation does not depend on a Mullerectomy, but instead is probably due to a combination of other factors: (1) a vertical posterior lamellar shortening; (2) secondary contractile cicatrization of the wound; and (3) plication or advancement of the Muller's smooth muscle-levator aponeurosis complex on the tarsus
— id: 24446, year: 1989, vol: 96, page: 413, stat: Journal Article,

Current concepts in dermis-fat grafting
Lisman RD; Smith BC; Nassif J
1989 Winter;29(4):252-264, International ophthalmologic clinics
— id: 63202, year: 1989, vol: 29, page: 252, stat: Journal Article,

Complications of blepharoplasty
Lisman, R D; Hyde, K; Smith, B
1988 Apr;15(2):309-335, Clinics in plastic surgery
Various involutional eyelid changes, such as fine rhytids, dynamic laugh lines in the lateral canthal area, secondary malar bags, and dermal pigmentation are not effectively treated by a blepharoplasty. Preoperative discussions are important to ensure that adequate expectations are held. Too often, a patient is informed that fine rhytids and dermal pigmentation can be successfully treated with lid surgery alone. The importance of the preoperative interview in determining patient expectations cannot be minimized. Preoperative ophthalmic and periocular examination is essential to identify any pre-existing pathology. Even though the surgical approach is adapted to the individual needs of each patient, the most meticulous of surgeons is predetermined to encounter his or her share of complications. There is a fine line between a 'complication' and a common, but unwanted, sequela of surgery. Patients, overwhelmingly, do have some widening of their palpebral fissures, even following conservative surgery. Unfortunately, this occasionally creates ocular irritation or gross discomfort in allergic or borderline dry eyed patients. Lower eyelid bowing is so common even in the face of minimal skin resection that we do not consider it a 'complication' if it does not produce a functional problem. It is humbling for all surgeons to review their blepharoplasty problems and helpful to recognize that, statistically, we are all due to face these events eventually
— id: 138851, year: 1988, vol: 15, page: 309, stat: Journal Article,

Experience with tarsal suspension as a factor in lower lid blepharoplasty
Lisman RD; Rees T; Baker D; Smith B
1987 Jun;79(6):897-905, Plastic & reconstructive surgery
The bowed lower eyelid, with scleral show, is a common but untoward result following blepharoplasty with even minimal skin excision. A number of conditions, unrecognized preoperatively, can predispose a patient to scleral show. These include eyelid laxity with or without atrophic orbicularis muscle tone, lax canthal tendons, hypoplastic malar eminences, unrecognized Graves' ophthalmopathy, unilateral high myopia, or the secondary blepharoplasty. Suspension of the tarsus of the lower eyelid, concomitant with or following blepharoplasty, can straighten bowed lids and provide 2 to 3 mm of elevation, if desired. A classification of patients likely to develop scleral show is presented along with a revised technique of tarsal suspension
— id: 51041, year: 1987, vol: 79, page: 897, stat: Journal Article,

Volkmann's ischemic contractures and blowout fractures
Lisman, R D; Smith, B C; Rodgers, R
1987 ;7:117-131, Advances in ophthalmic plastic & reconstructive surgery
Volkmann's ischemic contractures have long been recognized by orthopedic surgeons as a sequela of increased pressure within osseofascial muscle compartments. We present evidence that the same mechanism is a cause of fibrosis and contracture of extraocular muscles following orbital blowout fractures. Surgical treatment of a specific, recognizable type of blowout fracture is proposed
— id: 138853, year: 1987, vol: 7, page: 117, stat: Journal Article,

Efficacy of surgical treatment for paralytic ectropion
Lisman, R D; Smith, B; Baker, D; Arthurs, B
1987 Jun;94(6):671-681, Ophthalmology
Paralytic ectropion can be corrected with numerous procedures. Advocates of particular procedures have previously been unable to quote statistical rates of success for each procedure over significant lengths of time. This study reviews over 200 cases of paralytic ectropion, representing the spectrum of seventh nerve disease seen at an eye and ear specialty hospital and a general medical facility. Of all eyelid implantation devices 93 to 95% failed to work or needed reoperation by 3 years postoperatively. Soft tissue surgery without prosthetic implants or exoplants provided 60% success after a 3-year follow-up. Eyelid elevation or tightening coupled with surgery for facial reanimation produced a higher rate of success at 3 years (83%). An overwhelming number of patients (62%) complained of some degree of epiphora after any or all procedures. Based on these findings, soft tissue surgery without prosthetic implants or exoplants has a higher rate of success
— id: 138852, year: 1987, vol: 94, page: 671, stat: Journal Article,

Human bites of the eyelid
Spinelli, H M; Sherman, J E; Lisman, R D; Smith, B
1986 Nov;78(5):610-614, Plastic & reconstructive surgery
Five patients with traumatic colobomas of the eyelid secondary to human bites were surgically repaired with retrieved autogenous tissue. All patients were treated with prophylactic intravenous antibiotics. Surgical repair consisted of debridement of the autograft, meticulous layered closure of the autograft to the wound, and placement of a lid margin suture. In two of the patients, mild upper eyelid retraction was noted, and two patients had loss of cilia
— id: 138854, year: 1986, vol: 78, page: 610, stat: Journal Article,

Diplopia following blepharoplasty
Hayworth, R S; Lisman, R D; Muchnick, R S; Smith, B
1984 May;16(5):448-451, Annals of ophthalmology
The complication of extraocular muscle palsy following blepharoplasty is rare. In a review of 920 blepharoplasties at Manhattan Eye, Ear and Throat Hospital, three well-documented cases of diplopia following blepharoplasty could be found. Only one of these cases resolved within two months postoperatively. The explanation offered for this phenomenon is a Volkmann type contracture of the extraocular muscles following edema and hemorrhage into the muscle sheath
— id: 138856, year: 1984, vol: 16, page: 448, stat: Journal Article,

Eyelid and orbital treatment following radical maxillectomy
Smith, B; Lisman, R D; Baker, D
1984 Mar;91(3):218-228, Ophthalmology
Malignant lesions of the nasopharynx and paranasal sinuses often encroach upon the orbit. A series of nineteen patients who underwent partial or radical maxillectomy is presented to summarize the eyelid and orbital findings that required further treatment. Fifteen of these patients were left with an intact globe and a visually useful eye, but the defects of epiphora, eyelid malposition, dacryocystitis, and diplopia were visually threatening and required treatment. The cosmetic deformities and diplopia following maxillectomy and radiation are partially amenable to treatment with late bone grafting. Lacrimal outflow deficiencies were successfully treated with dacryocystorhinostomy. Only patients with ocular complications following maxillectomy are included in this series; therefore, the range of problems and their treatment confronting the ophthalmologist is summarized
— id: 138857, year: 1984, vol: 91, page: 218, stat: Journal Article,

Volkmann's contracture of the extraocular muscles following blowout fracture
Smith, B; Lisman, R D; Simonton, J; Della Rocca, R
1984 Aug;74(2):200-216, Plastic & reconstructive surgery
In the past decade there has been considerable controversy over the surgical indications for treatment of blowout fractures of the orbit. It has been well recognized that some fracture patients develop an ischemic contracture of the inferior rectus muscle. We have found that a Volkmann's type of contracture of the inferior rectus muscle does exist and is similar to that found in the distal extremities. A specific group of fracture patients is at greater risk for development of a contracture. Elderly patients, hypotensive patients, patients with small fractures, and those with high inferior rectus compartment pressures are more prone to developing a contracted extraocular muscle. We have measured compartment pressures in 18 patients who were surgical candidates following orbital fracture. Our conclusions indicate that surgical intervention following blowout fractures in these high-risk patients may be more prudent than medical management. Patients with persistent diplopia due to a contracted inferior rectus are extremely difficult to treat many months after fracture. We still believe it prudent to surgically repair orbital fractures in patients with diplopia, enophthalmos, and a risk for muscle contracture. The documentation of this additional sequela of unrepaired fractures lends more strength to this belief. There is no evidence to indicate that a Volkmann's contracture would be possible after early repair of a blowout fracture
— id: 138855, year: 1984, vol: 74, page: 200, stat: Journal Article,

Dermis-fat orbital implantation: 118 cases
Smith, B; Bosniak, S; Nesi, F; Lisman, R
1983 Nov;14(11):941-943, Ophthalmic surgery
During the previous six years the authors have performed 118 dermis-fat orbital implants. Fifty-one were primary implantations performed at the time of enucleation. Nineteen grafts were implanted after migrated implants were removed, and 19 grafts were used to correct superior sulcus deformities. Nine dermis-fat grafts expanded contracted sockets. It is becoming increasingly clear that these autogenous implants are effective in maintaining orbital volume while preserving the fornicies and conserving the conjunctiva. Although significant atrophy of primary grafts does not occur very frequently, it is more common in cases of secondary implantation, particularly in cases of chemically injured severely contracted sockets (3 of 9 cases). We have noted only one case of significant atrophy following a primary procedure. This occurred two and a half years following an apparently successful primary graft
— id: 138858, year: 1983, vol: 14, page: 941, stat: Journal Article,

Dacryoadenopexy as a recognized factor in upper lid blepharoplasty
Smith, B; Lisman, R D
1983 May;71(5):629-632, Plastic & reconstructive surgery
The recognition of a herniated lacrimal gland is done by simple examination; it is not usually taught to plastic surgeons. Fullness in the superotemporal aspect of an upper eyelid in younger patients often represents a ptotic gland. Suspension of the glands improves the surgical result of upper-lid blepharoplasty without compromising lacrimal outflow
— id: 138859, year: 1983, vol: 71, page: 629, stat: Journal Article,

Use of sclera and liquid collagen in the camouflage of superior sulcus deformities
Smith, B; Lisman, R D
1983 Mar;90(3):230-235, Ophthalmology
The cosmetic deformities following enucleation are often unavoidable. Loss of orbital volume and atrophy of orbital fat create significant enophthalmos. The literature is filled with numerous procedures that add to the orbital volume of the anophthalmic socket. An outline of three procedures to the upper eyelid to camouflage an enophthalmic appearance are presented. These can be used alone or in conjunction with an 'orbital volume increasing' procedure. Two procedures can be used in an office setting to alleviate small deformities; 19 patients have been treated in this manner with a follow-up period of up to 26 months
— id: 138860, year: 1983, vol: 90, page: 230, stat: Journal Article,

An autogenous kinetic dermis-fat orbital implant: an updated technique
Smith, B; Bosniak, S L; Lisman, R D
1982 Sep;89(9):1067-1071, Ophthalmology
— id: 138862, year: 1982, vol: 89, page: 1067, stat: Journal Article,

Preparation of split thickness auricular cartilage for use in ophthalmic plastic surgery
Smith, B; Lisman, R D
1982 Dec;13(12):1018-1021, Ophthalmic surgery
Auricular cartilage can be used extensively in a number of procedures by the ophthalmic plastic surgeon. It is ideal for the lengthening of eyelids, and also has a place in eyelid reconstruction, surgery for trichiasis, and the anophthalmic socket. It is vital that the cartilage be prepared in a precise and meticulous manner in order to insure optimum results
— id: 138861, year: 1982, vol: 13, page: 1018, stat: Journal Article,

Blowout fracture of the orbit
Smith, B; Lisman, R
1981 Oct;92(4):592-593, American journal of ophthalmology
— id: 138863, year: 1981, vol: 92, page: 592, stat: Journal Article,

Cosmetic correction of eyelid deformities associated with exophthalmos
Smith, B; Lisman, R D
1981 Oct;8(4):777-792, Clinics in plastic surgery
— id: 138864, year: 1981, vol: 8, page: 777, stat: Journal Article,