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Advances in Oculoplastic Surgery and Ocular Surface Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (15 January 2026) | Viewed by 3195

Special Issue Editors


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Guest Editor
Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
Interests: ophthalmic plastic & reconstructive surgery; cosmetic surgery of the eyelids and face; surgery of the eyelids, lacrimal system, and orbit; facial fillers and botulinum toxin injections; blepharospasm and hemifacial spasm; thyroid eye disease

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Guest Editor
1. Orbital and Adnexal Service, Tiberia Hospital-GVM Care and Research, Rome, Italy
2. Oftalmoplastica Roma, Rome, Italy
3. Faculty of Medicine and Surgery, University of Pavia, Pavia, Italy
4. Department of Translational Medicine, University of Ferrara, Ferrara, Italy
Interests: socket surgery; pediatric oculoplastic surgery; eyelid and orbital tumors; lacrimal surgery; thyroid eye disease

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Guest Editor Assistant
S. Eugenio and Sandro Pertini Hospitals, ASL Roma 2, Rome, Italy
Interests: ophthalmology; corneal surgery; ocular surface disease

Special Issue Information

Dear Colleague,

This Special Issue of the Journal of Clinical Medicine brings together current evidence and surgical innovation at the intersection of ocular surface disease, corneal pathology, and oculoplastic surgery. Special emphasis is placed on corneal neurotization, a rapidly advancing technique offering significant benefits in the management of neurotrophic keratopathy, highlighting surgical methods, indications, and functional outcomes related to restoration of corneal sensitivity and epithelial healing. The issue explores the role of corneal innervation in maintaining surface integrity and presents insights into tissue remodeling following nerve injury. The therapeutic application of hemocomponents, including autologous serum and platelet-rich plasma, is evaluated for their neurotrophic and anti-fibrotic potential. Eyelid malpositions, seventh nerve palsy, and thyroid eye disease are examined for their impact on the ocular surface, with discussion of surgical techniques to address exposure-related corneal damage. Articles also address dry anophthalmic socket syndrome, emphasizing its inflammatory and tear film alterations. Advances in artificial intelligence for diagnosis and management of complex ocular surface conditions are also featured, reflecting the growing role of technology in clinical decision-making.

Prof. Dr. Michael T. Yen
Dr. Francesco Quaranta Leoni
Guest Editors

Dr. Balestrazzi Alessandra
Guest Editor Assistant

Manuscript Submission Information

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Keywords

  • ocular surface disease
  • corneal neurotization
  • neurotrophic keratopathy
  • eyelid malposition
  • facial nerve palsy
  • thyroid eye disease
  • oculoplastic surgery
  • hemocomponents
  • dry anophthalmic socket
  • corneal pathology
  • ocular surface reconstruction
  • exposure keratopathy

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Published Papers (3 papers)

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Review

25 pages, 669 KB  
Review
The Role of Innervation in Ocular Surface Homeostasis, Tissue Remodeling Following Nerve Injury, and the Therapeutic Potential of Hemocomponents in Neuronal and Cicatricial Pathologies
by Giulio Ferrari, Silvia Odorici, Matteo Menean, Antonio Di Zazzo, Piera Versura and Alessandra Micera
J. Clin. Med. 2026, 15(5), 2026; https://doi.org/10.3390/jcm15052026 - 6 Mar 2026
Viewed by 488
Abstract
The ocular surface is a neuro–epithelial–immune unit in which corneal innervation is essential for maintaining tissue integrity and visual function. Sensory nerves regulate reflex tearing and blinking, provide trophic support, and modulate local immune responses. Nerve injury resulting from trauma, surgery, infection, systemic [...] Read more.
The ocular surface is a neuro–epithelial–immune unit in which corneal innervation is essential for maintaining tissue integrity and visual function. Sensory nerves regulate reflex tearing and blinking, provide trophic support, and modulate local immune responses. Nerve injury resulting from trauma, surgery, infection, systemic disease, or chronic inflammation disrupts epithelial homeostasis and may lead to neurotrophic keratopathy, neuropathic pain, and pathological remodeling. Beyond classical neurotrophic disease, nerve dysfunction contributes to severe dry eye and immune-mediated cicatricial disorders. Depending on the neuro-inflammatory context, remodeling may evolve toward stromal thinning, as in keratoconus, or progressive fibrosis, as in ocular cicatricial pemphigoid. Blood-derived eye drops, including serum- and platelet-based formulations, represent biologically active therapies that support epithelial repair and nerve regeneration, although greater standardization is needed. Full article
(This article belongs to the Special Issue Advances in Oculoplastic Surgery and Ocular Surface Diseases)
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14 pages, 482 KB  
Review
Dry Anophthalmic Socket Syndrome—A Narrative Review
by Daniele Lorenzano, Alberto Chierigo and Alessandra Claudia Modugno
J. Clin. Med. 2025, 14(24), 8814; https://doi.org/10.3390/jcm14248814 - 12 Dec 2025
Viewed by 748
Abstract
Dry Anophthalmic Socket Syndrome (DASS) is a multifactorial condition that affects roughly half of all prosthetic eye wearers and remains frequently underrecognized. It is characterised by symptoms such as dryness, discomfort, discharge, and inflammation of the socket surface. Diagnostic criteria include validated symptom [...] Read more.
Dry Anophthalmic Socket Syndrome (DASS) is a multifactorial condition that affects roughly half of all prosthetic eye wearers and remains frequently underrecognized. It is characterised by symptoms such as dryness, discomfort, discharge, and inflammation of the socket surface. Diagnostic criteria include validated symptom questionnaires (e.g., OSDI, DEQ-5, SANDE) and at least one clinical sign such as conjunctival staining, blepharitis, or reduced tear meniscus height. This review describes the anatomical, cellular, and molecular changes associated with DASS. Meibomian gland dysfunction is common, with a significant reduction in gland density and structure. Goblet cell density is also often decreased, particularly in the tarsal and bulbar conjunctiva, although findings may be affected by topical treatments. Increased conjunctival inflammation—evidenced by immune cell infiltration and elevated markers such as MMP-9 and ICAM-1—is frequently observed, particularly in the posterior socket lining. Oxidative stress, mediated by dysregulated NOX4, KEAP1, and NRF2 expression, appears to play a contributory role. Additional factors influencing DASS include eyelid malpositions such as entropion and ectropion, prosthesis smoothness and amount of tear film production. Poor hygiene practices and environmental factors may exacerbate symptoms. Given its multifactorial aetiology, DASS requires a complex management strategy targeting inflammation, tear film instability, mechanical irritation, eyelid position and patient education. Increased awareness, standardised diagnostics, and evidence-based care protocols are critical to improving outcomes for prosthetic eye wearers. Full article
(This article belongs to the Special Issue Advances in Oculoplastic Surgery and Ocular Surface Diseases)
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19 pages, 1407 KB  
Review
Eyelid Malpositions and Ocular Surface Disease: Clinical Correlations and Management Strategies
by Francesco M. Quaranta Leoni, Nazareno Marabottini, Adriana Iuliano, Diego Strianese and Gustavo Savino
J. Clin. Med. 2025, 14(23), 8523; https://doi.org/10.3390/jcm14238523 - 1 Dec 2025
Cited by 1 | Viewed by 1480
Abstract
Eyelid retraction, cicatricial entropion, and deformities associated with facial nerve palsy are among the eyelid malpositions most detrimental to the ocular surface, as they cause exposure, tear film instability, inflammation, and potentially significant visual impairment. These conditions present major functional and esthetic challenges, [...] Read more.
Eyelid retraction, cicatricial entropion, and deformities associated with facial nerve palsy are among the eyelid malpositions most detrimental to the ocular surface, as they cause exposure, tear film instability, inflammation, and potentially significant visual impairment. These conditions present major functional and esthetic challenges, underscoring the need for a clear understanding of their mechanisms and management. A narrative review was conducted using PubMed, MEDLINE, Embase, and Google Scholar to identify English and non-English studies (with English abstracts) addressing eyelid malpositions related to thyroid eye disease, cicatricial processes, and facial nerve palsy. Screening and cross-referencing yielded 115 relevant publications. Studies were excluded if they lacked clinical relevance, did not address the target disorders, involved animals, consisted of insufficient case reports, lacked an English abstract, or were non–peer-reviewed or duplicated. Extracted information included patient demographics, clinical presentations, diagnostic methods, treatments, complications, and outcomes. In thyroid eye disease, eyelid retraction results from adrenergic overstimulation, increased Müller muscle tone, and fibrosis involving the levator–superior rectus complex. Temporary improvement may be achieved with botulinum toxin, corticosteroids, or soft-tissue fillers, whereas sustained correction requires individualized surgical approaches. Cicatricial entropion arises from posterior lamellar contraction caused by inflammatory or iatrogenic injury and is best treated with lamellar repositioning or grafting procedures. In facial nerve palsy, incomplete blinking, punctal malposition, and lacrimal pump dysfunction contribute to tearing and ocular surface instability; management prioritizes corneal protection, eyelid rebalancing, and adjunctive measures such as botulinum toxin or physiotherapy. Across all conditions, tailored, multidisciplinary care is essential to maintain ocular surface integrity, restore eyelid function, and preserve quality of life. Full article
(This article belongs to the Special Issue Advances in Oculoplastic Surgery and Ocular Surface Diseases)
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