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Ophthal Plast Reconstr Surg [JOURNAL]

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Elastase-Treated Auricular Cartilage: Feasibility as a Substitute for Native Tarsus.

Meer E, Goodyear K, Park J … +4 more , Jafari S, Mirchia K, Demer J, Karlin J

Ophthalmic Plast Reconstr Surg · 2026 May-Jun 01 · PMID 41528945 · Publisher ↗

PURPOSE: Reconstruction of upper eyelid defects is challenging due to paucity of fungible local tissue and a lack of adequate tarsal substitutes. Cartilage is too stiff to be directly implanted in the posterior lamella d... PURPOSE: Reconstruction of upper eyelid defects is challenging due to paucity of fungible local tissue and a lack of adequate tarsal substitutes. Cartilage is too stiff to be directly implanted in the posterior lamella due to the risk of corneal damage with blinking. Since elastin is a key structural element in elastic cartilage, the authors hypothesized that elastase treatment of cartilage may reduce cartilage's stiffness sufficiently to make it a feasible posterior eyelid lamella substitute. METHODS: Porcine auricular cartilage was treated with elastase or buffer control. Histopathology, electron microscopy, and mechanical testing were performed. Young's modulus was calculated using the Hertzian method for mechanical indentation testing at baseline, 2, and 24 hours. Group 1 (buffer control auricular cartilage), Group 2 (elastase-treated auricular cartilage), and Group 3 (native tarsus) were compared. RESULTS: Grossly, elastase treatment increased cartilage flexibility, and microscopically increased chondrocyte lacunae and decreased the density of the interterritorial matrix, relative to controls. Electron microscopy revealed elastin fiber degradation with empty channels preplacing elastin fibers. At 2 hours, cartilage stiffness showed minimal differences between Groups 1 and 2 for both instantaneous modulus (1.34 vs. 1.37 MPa; p = 0.92) and equilibrium modulus (0.31 vs. 0.36 MPa; p = 0.71). By 24 hours, the equilibrium modulus of elastase-treated cartilage (0.055 MPa) resembled native tarsus (0.016 MPa; p = 0.76). CONCLUSIONS: Grossly, elastase treatment increased cartilage flexibility and, microscopically, increased chondrocyte lacunae and decreased the density of the interterritorial matrix, relative to controls.
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Pediatric Ocular Adnexal Lymphoma: Past, Present, and Future.

Walsh KL, McCartney MH, Fraser CJ … +1 more , Sullivan TJ

Ophthalmic Plast Reconstr Surg · 2026 Jan · PMID 41528943 · Publisher ↗

PURPOSE: To characterize the clinical, imaging, and pathological spectrum of pediatric ocular adnexal lymphomas tumors (OAL), including both primary and secondary lesions, using contemporary World Health Organization Hae... PURPOSE: To characterize the clinical, imaging, and pathological spectrum of pediatric ocular adnexal lymphomas tumors (OAL), including both primary and secondary lesions, using contemporary World Health Organization Haematolymphoid (5th edition) classification. METHODS: This retrospective case series included patients <18 years with biopsy-proven lymphoma of the orbit or ocular adnexa managed by a single oculoplastic surgeon over a 30-year period. Demographic, clinical, imaging, histopathological, treatment, and outcome data were collected. Lesions were categorized as primary (confined to ocular adnexa with or without regional lymph nodes) or secondary (ocular adnexa involved as part of systemic lymphoproliferative disease). RESULTS: Eleven patients (median age 11 years; 6 male) were identified. Five (45%) had precursor B-cell lymphoblastic leukemia/lymphoma, and 3 (27%) had mature B-cell tumors, including 2 extranodal marginal zone lymphomas and 1 diffuse large B-cell lymphoma. Three (27%) had mature natural killer/T-cell neoplasms, including 1 primary cutaneous anaplastic large cell lymphoma, 1 anaplastic large cell lymphoma, and 1 extranodal natural killer/T-cell lymphoma, nasal type. Six patients (55%) presented with ocular adnexal involvement secondary to systemic disease, most commonly in the orbit. Periorbital swelling, proptosis, and palpable masses were the predominant ocular signs. Management ranged from surgical excision or topical interferon to systemic chemotherapy, radiotherapy, and hematopoietic stem-cell transplantation. At the last follow-up, outcomes varied with histological subtype and disease stage. CONCLUSIONS: Pediatric ocular adnexal lymphomas displays striking clinicopathologic heterogeneity, with a predominance of precursor lymphoblastic neoplasms and a notable proportion of high-grade mature B- and T/NK-cell lymphomas. Recognizing both primary and secondary lesions and applying accurate histopathological classification are critical for timely diagnosis and to guide modern targeted therapies. This series expands the evidence base for a rare disease and underscores the importance of integrating ophthalmic assessment with contemporary World Health Organization diagnostic frameworks.
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Functional Improvement in Cranial Neuropathies From Perineural Cutaneous Squamous Cell Carcinoma After Immunotherapy: A Multicenter Case Series and Review.

Saffari PS, Lucarelli KM, Homer NA … +10 more , Wolkow N, Tooley AA, Goldberg RA, Rootman DB, Badilla J, Liu D, Kim IA, Demirci H, Juntipwong S, Roelofs KA

Ophthalmic Plast Reconstr Surg · 2026 Mar-Apr 01 · PMID 41528941 · Publisher ↗

PURPOSE: Cutaneous squamous cell carcinoma has a propensity for perineural invasion. Treating perineural spread has involved surgery and adjuvant chemoradiation, and more recently, immune checkpoint inhibitors. This stud... PURPOSE: Cutaneous squamous cell carcinoma has a propensity for perineural invasion. Treating perineural spread has involved surgery and adjuvant chemoradiation, and more recently, immune checkpoint inhibitors. This study aims to evaluate motor and sensory functional outcomes in patients with cranial neuropathies from perineural spread of squamous cell carcinoma, particularly those undergoing immunotherapy. METHODS: This was a multicenter case series and literature review. RESULTS: Eighteen patients with cranial neuropathies from perineural spread had a mean age of 72.5 ± 9.7 years. Cranial nerves V and VII were most often involved. Treatments included radiotherapy (8/18; 44.4%), chemotherapy (7/18; 38.9%), and/or immunotherapy (11/18; 61.1%), with many receiving a combination of modalities (8/18; 44.4%). Of those receiving immunotherapy, 72.7% (8/11) demonstrated at least partial clinical and/or radiologic tumor response. Among those with functional outcomes documented, half had improvement in sensory/motor nerve function following immunotherapy (4/8; 50%). A literature review identified 55 articles describing 449 patients total with cranial neuropathies from squamous cell carcinoma perineural spread. Combinations of surgery, chemotherapy, and/or radiotherapy were employed, with immunotherapy used in 16 patients. From 5 patients on immunotherapy with documented functional outcomes, all demonstrated at least some improvement. CONCLUSION: Immunotherapy plays an evolving role in managing advanced squamous cell carcinoma. Functional improvements in cranial neuropathy were demonstrated in 50% of patients receiving treatment with immunotherapy at a mean of 32.6 months of follow-up. This may hold important implications for the timing of surgical intervention, particularly in the case of cranial nerves V and VII palsies.
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Periphlebitis of the Superior Ophthalmic Vein in Noninflammatory Thyroid Eye Disease.

E Cruz AAV, Montenegro G, Facchin MPS … +1 more , Rocha VH

Ophthalmic Plast Reconstr Surg · 2026 May-Jun 01 · PMID 41506244 · Publisher ↗

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A Case of Periocular Factitious Dermatitis in an Adult.

Tori K, Han M, Lee HBH

Ophthalmic Plast Reconstr Surg · 2026 Jul-Aug 01 · PMID 41492896 · Publisher ↗

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Accessory Extraocular Muscle With Inflammatory Enlargement: A Rare Presentation.

França John J, Eifer DA, da Silveira Dalla-Bona JP … +1 more , Procianoy F

Ophthalmic Plast Reconstr Surg · 2026 Jul-Aug 01 · PMID 41492893 · Publisher ↗

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A Rare Case of Metastatic Papillary Thyroid Carcinoma Presenting as an Invasive Orbital Mass.

Chen NA, Chen TH, Yuan S … +2 more , Estopinal MDV, Tao JP

Ophthalmic Plast Reconstr Surg · 2026 Jul-Aug 01 · PMID 41492892 · Publisher ↗

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Reply Re: "Effect of Cannabis Usage on Thyroid Eye Disease".

Zong AM, Barmettler A

Ophthalmic Plast Reconstr Surg · 2026 Jan-Feb 01 · PMID 41490342 · Publisher ↗

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Re: "Effect of Cannabis Usage on Thyroid Eye Disease".

Butt FR, Wu KY, Bélanger P

Ophthalmic Plast Reconstr Surg · 2026 Jan-Feb 01 · PMID 41490341 · Publisher ↗

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Reply Re: "A Safer and Easier Method to Open the Orbital Septum: Septal Ballooning".

Kim J, Kim Y, Woo KI

Ophthalmic Plast Reconstr Surg · 2026 Jan-Feb 01 · PMID 41490340 · Publisher ↗

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Re: "A Safer and Easier Method to Open the Orbital Septum: Septal Ballooning".

Castillo-Fernández M, Castillo-Laguarta JM

Ophthalmic Plast Reconstr Surg · 2026 Jan-Feb 01 · PMID 41490339 · Publisher ↗

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Reply Re: "A Safer and Easier Method to Open the Orbital Septum: Septal Ballooning".

Kim J, Kim Y, Woo KI

Ophthalmic Plast Reconstr Surg · 2026 Jan-Feb 01 · PMID 41490338 · Publisher ↗

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Re: "A Safer and Easier Method to Open the Orbital Septum: Septal Ballooning".

Diab MM

Ophthalmic Plast Reconstr Surg · 2026 Jan-Feb 01 · PMID 41490337 · Publisher ↗

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Reply Re: "Progress of Baggy Eyelid: An Anatomical Study".

Kakizaki H

Ophthalmic Plast Reconstr Surg · 2026 Jan-Feb 01 · PMID 41490336 · Publisher ↗

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Re: "Progress of Baggy Eyelid: An Anatomical Study".

Putterman AM

Ophthalmic Plast Reconstr Surg · 2026 Jan-Feb 01 · PMID 41490335 · Publisher ↗

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Reply Re: "Levator Muscle Complex Exploration During Surgery for Simple Severe Congenital Ptosis".

Diab MM, Alahmadawy YA, Ahmed RA … +1 more , Allen RC

Ophthalmic Plast Reconstr Surg · 2026 Jan-Feb 01 · PMID 41490334 · Publisher ↗

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Re: "Levator Muscle Complex Exploration During Surgery for Simple Severe Congenital Ptosis".

Jiang M D M

Ophthalmic Plast Reconstr Surg · 2026 Jan-Feb 01 · PMID 41490333 · Publisher ↗

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Reply Re: "Risk of Blindness from Temple Filler Injections: Investigating Vascular Anastomoses Between the Deep Temporal and Ophthalmic Arteries".

Woodward JA, Sheth N

Ophthalmic Plast Reconstr Surg · 2026 Jan-Feb 01 · PMID 41490332 · Publisher ↗

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Re: "Risk of Blindness from Temple Filler Injections: Investigating Vascular Anastomoses Between the Deep Temporal and Ophthalmic Arteries".

Steinsapir KD

Ophthalmic Plast Reconstr Surg · 2026 Jan-Feb 01 · PMID 41490331 · Publisher ↗

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Reply Re: "The Preaponeurotic Fat Advancement Pedicle for Correction of Upper Eyelid Volume Asymmetry: A Case Series".

Conger JR, Pfeiffer ML, Lo C … +1 more , Samimi DB

Ophthalmic Plast Reconstr Surg · 2026 Jan-Feb 01 · PMID 41490330 · Publisher ↗

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