Search Results (9)

Background: Biodegradable Temporizing Matrix (BTM) is a synthetic, biodegradable polyurethane dermal substitute that promotes neodermis formation and supports re-epithelialization by secondary intention. However, published experience with BTM in facial reconstruction is limited to small case series with narrow anatomic indications, and its performance across multiple distinct facial subunits has not been systematically characterized. Methods: A retrospective case series was conducted of all patients who underwent nasal, periocular, or scalp reconstruction with BTM following Mohs micrographic surgery (MMS) at a single tertiary academic center. Patient demographics, defect characteristics, healing times, complications, and secondary procedures were recorded. Results: A total of 135 patients were included: 67 nasal, 40 periocular, and 28 scalp. Overall complication rates were 7.5%, 20.0%, and 17.9%, respectively. The majority of patients across all sites achieved definitive coverage by secondary intention without skin grafting. Lower eyelid involvement was the strongest independent predictor of ocular complications in the periocular cohort, and prior radiation was the dominant predictor of scalp complications. Conclusions: In this retrospective series, BTM demonstrated favorable outcomes for facial reconstruction following MMS across nasal, periocular, and scalp subunits, reliably supporting secondary re-epithelialization and functioning as definitive reconstruction, a temporizing agent, and a lining adjunct for staged forehead flap reconstruction. Prospective comparative studies are needed to confirm these findings. Full article

Background: Eyelid malignancies require accurate intraoperative margin control to achieve complete tumor excision while preserving the functional and aesthetic integrity of the periocular region. Mohs micrographic surgery (MMS) is widely regarded as the reference standard for margin-controlled excision, whereas frozen section–controlled excision (FSC) represents a reliable and widely used alternative in oculoplastic practice. In parallel, several emerging imaging technologies are being investigated to improve real-time tumor detection and surgical precision. Methods: A narrative review of the literature was conducted to summarize current evidence on intraoperative margin control in eyelid tumor surgery. The review focused on established surgical techniques, including MMS and FSC, as well as emerging imaging modalities such as fluorescence confocal microscopy, reflectance confocal microscopy, optical coherence tomography, line-field confocal optical coherence tomography, photoacoustic imaging, and artificial intelligence (AI)-assisted analysis. Results: MMS provides complete circumferential peripheral and deep margin assessment and remains the benchmark for high-risk, recurrent, and poorly defined periocular tumors, particularly basal cell carcinoma. FSC offers favorable oncologic outcomes, allows immediate reconstruction, and remains an effective option when MMS is not available. Emerging imaging modalities have shown promising diagnostic performance for tumor detection, presurgical mapping, and intraoperative support, particularly in basal cell carcinoma, although evidence in periocular tumors remains limited for most techniques. AI-assisted approaches have also demonstrated high accuracy in the interpretation of frozen sections and optical imaging data, suggesting potential to improve workflow efficiency and diagnostic consistency. Conclusions: MMS and FSC remain the current standards for intraoperative margin control in eyelid tumor surgery. Emerging imaging technologies and AI-based tools may further enhance surgical precision and tissue preservation, but most remain investigational in the periocular setting. Further prospective studies are needed to validate their clinical utility, define standardized workflows, and clarify their role alongside established histopathologic techniques. Full article

Background/Objectives: Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists have revolutionised obesity and type 2 diabetes management through effective weight loss and metabolic regulation. However, their increasing use has led to reports of adverse aesthetic and functional effects, particularly affecting facial and ocular tissues. Methods: A comprehensive literature review was conducted in October 2025 across PubMed, Embase, and Medline using the terms “GLP-1 receptor agonist,” “Ozempic face,” “facial lipoatrophy,” “ocular surface disease,” “orbital fat,” and related combinations. Studies reporting facial, periorbital, orbital, or ocular surface changes associated with GLP-1 or GLP-1/GIP receptor agonists were included. Reference lists were screened to identify additional sources. Results: Evidence suggests that GLP-1 and dual GLP-1/GIP receptor agonists may contribute to rapid facial volume loss, dermal fat atrophy, and periocular hollowing—collectively termed “Ozempic face.” The mechanism is multifactorial, involving both weight-loss-related fat depletion and potential modulation of adipocyte differentiation. Ocular surface improvements have been observed in some studies. Radiologic data demonstrate preferential superficial midface fat loss, informing potential aesthetic correction strategies. Conclusions: GLP-1-based therapies, while clinically effective, can result in perceptible adnexal and periocular changes with aesthetic and functional implications. Awareness of these effects is crucial for multidisciplinary management. Future prospective studies are warranted to clarify mechanisms and guide individualised reconstructive and rejuvenative interventions. Full article

A 10-year-old male neutered British Shorthair cat with diabetes mellitus presented with an acute onset of unilateral swelling, erythema, alopecia and coalescing ulcerations of the face and periocular skin. Initial clinical differential diagnoses were trauma, infections (including feline respiratory viruses), arthropod bites, and eosinophilic dermatoses such as eosinophilic granuloma complex, mosquito-bite hypersensitivity and cutaneous adverse drug reaction. Histopathology revealed fulminant furunculosis with abundant eosinophils and vasculitis. Initial topical glucocorticoid treatment partially improved the clinical signs but severely raised serum glucose levels. As a result, systemic glucocorticoids and ciclosporin were not considered optimal treatments, and the off-label and short-term use of oclacitinib was chosen with the owner’s informed consent. This treatment induced fast remission of clinical signs with no recurrence for 17 months. Secondary fusion of the eyelids caused by cicatrization was surgically reconstructed to restore full function. Full article

Background: Periocular necrotizing fasciitis (PNF) is a rare but life-threatening emergency that requires immediate recognition, as delayed diagnosis can worsen patient outcomes. To address this critical issue, we conducted the largest and most comprehensive systematic review to date, providing valuable insights into the diagnosis and treatment of PNF to improve clinical practice and patient prognosis. Methods: A search on Pubmed, Scopus, Embase, and WOS from January 2013 to August 2024 was performed. Only the cases of NF affecting the periocular region were included with no age limitations. Article selection and data extraction were performed independently by two investigators to avoid bias. Bias on individual studies is low as they represent case reports or case series, and publication bias is partially addressed including all the large case series even if no individual data could be retrieved. Results: The cohort included a total of 183 patients with PNF, with detailed patient-specific data for 107 individuals and only aggregated data for another 76. The average age at diagnosis was 54.2 years, and females constituted 44% of the population sample. Notably, 49.6% of the patients were immunocompromised. Streptococcus pyogenes was the predominant causative organism, identified in 79.8% of the cases. Most infections were unilateral (72.1%) without extension beyond the periocular area (54.7%). Most patients (89.6%) underwent surgical debridement alongside intravenous antibiotics. Septic shock occurred in 26.8% of the patients, and the overall mortality rate was 4.9%. Visual acuity was unaffected in 67.5% of the patients, though 18.2% progressed to blindness on the affected side. Reconstructive efforts predominantly involved skin grafting, both free and local pedunculate flaps as well as secondary healing in some instances. Conclusions: This systematic review summarizes the understanding of periocular necrotizing fasciitis’ (PNF) demographic trends, clinical manifestations, causative pathogens, and patient outcomes. Vigilance for PNF should be heightened when the clinical assessment of the patient’s eyelids reveals rapidly spreading edema and induration, subcutaneous emphysema, or necrotic bullae and/or eschar. Prompt identification and expedited intervention, including debridement and targeted antibiotic therapy, critically influence prognosis. Despite optimal management, patients may still suffer from significant aesthetic impairment, severe complications such as vision loss, or death due to septic shock. Full article

Objectives: Visual field (VF) testing is key to assessing functional loss in glaucoma. Despite its clinical value, traditional VF testing has a number of limitations, including its dependency on medical equipment and posturing requirements. The present study examines the acceptance, tolerability, and comfort of home-based VF testing using a virtual reality (VR) headset. Method: Healthy subjects were prospectively enrolled to undergo VF examination in a non-clinical setting using a commercially available stereoscopic VR headset and SORS (sequentially optimized reconstruction strategy) on the VisionOne platform. Subjects were supervised and wore their own spectacles within the headset. After the VR VF test, they were asked about their comfort, side effects, and readiness to repeat the examination at home. Results: Of the 12 subjects enrolled, 7 were female (58.3%) and 5 were male (41.7%). Mean age was 45 years (range: 30–68). While none of the subjects suffered from glaucoma, their medical histories included severe arthritis, refractive surgery, high myopia, amblyopia, and esotropia. The mean self-reported comfort score was 8.75 out of 10 (range: 8–10), with some subjects taking the test in the dorsal decubitus position. Eleven subjects (91.7%) considered the device to be easy to use, and 100% responded that they would be willing to repeat the test at home, of which 41.7% stated they would prefer to be supervised by a clinician. Overall, three subjects reported mild side effects, namely light asthenopia, epiphora, and periocular flushing. All side effects were mild and self-limited. The mean perceived duration of the test (187 s) correlated strongly with the mean actual duration (166 s; Pearson correlation coefficient r = 0.76, p-value = 0.007). In all, 58.3% of perceived durations were shorter than the actual test durations. Mean false negative and false positive responses were 3.75% and 4.7%, respectively. Central fixation recorded by real-time eye tracking was maintained on average 73.23% of the time and showed a strong correlation with false negative responses (r = 0.75; p = 0.026). Conclusions: While the present study did not examine the test algorithm itself, it suggests that home-based VF testing using a VR headset is well tolerated and accepted, with high levels of self-reported comfort and only mild side effects. While all subjects welcomed the opportunity to perform clinical tests from home, over a third expressed a preference for supervision. Real-time eye tracking correlated well with traditional reliability markers, suggesting potential clinical value. Full article

Background: Malignant eyelid tumours present a considerable challenge in the field of ophthalmic oncology, necessitating a combination of precision oncological care and meticulous reconstruction to ensure the preservation of eyelid functionality and the maintenance of facial aesthetics. Method: This study presents a review of the outcomes of 167 patients who underwent eyelid reconstruction following the excision of primary non-melanocytic malignant tumours. The choice of reconstruction technique was dependent on a number of factors, including the stage of the tumour, its location, and the characteristics of the patient. The most commonly used techniques included regional flaps, local flaps, and skin grafts. The most frequently employed reconstruction techniques were forehead flaps (59 cases), simple excisions (38 cases), and Mustarde cheek flaps (16 cases). Result: The postoperative complications, including ectropion, epiphora, and flap necrosis, were recorded. However, no significant correlation was found between the risk of complications and either the location of the tumour or the reconstruction method employed. Despite the complexity of medial canthal and lower eyelid reconstruction, satisfactory aesthetic and functional outcomes were generally achieved. Conclusions: This study emphasises the importance of individualised surgical planning, highlighting the advantages and limitations of various techniques to optimise both the functional and aesthetic results. Full article

Iris recognition, which is known to have outstanding performance among conventional biometrics techniques, requires a high-resolution camera and a sufficient amount of lighting to capture images containing various iris patterns. To address these issues, research is actively conducted on ocular recognition to include a periocular region in addition to the iris region, which also requires a high-resolution camera to capture images, indicating limited applications due to costs and size limitation. Accordingly, this study proposes an ocular super-resolution cycle-consistent generative adversarial network (OSRCycleGAN) for ocular super-resolution reconstruction, and additionally proposes a method to improve recognition performance in case that ocular images are acquired at a low-resolution. The results of the experiment conducted using open databases, namely, CASIA-iris-Distance and Lamp v4, and IIT Delhi iris database, showed that the equal error rate of recognition of the proposed method was 3.02%, 4.06% and 2.13% for each database, respectively, which outperformed state-of-the-art methods. Full article

Objectives. Basal cell carcinomas (BCCs) are malignant tumors which rarely metastasize, are slow-growing, and extensively locally destructive. BCCs more than 5 cm in diameter are defined as giant. Most often they arise as a result of neglect, as the patient avoids, delays, or refuses to see a doctor. The large tumor diameter and consequently of the post-excisional defect make these lesions difficult to treat surgically with respect to selecting the surgical reconstruction technique. Method. We studied a group of 9 patients, aged 60 to 85 years, diagnosed with giant basal cell carcinomas (GBCCs) with periocular location in which surgery was indicated. Results. In all cases, complete excision with histologically clear margins was performed and for the coverage of the remaining defect various, complex, and sometimes two-stage reconstructive techniques were used. Conclusions. Giant cell carcinoma of the periocular region requires extensive and risky surgery, especially when performed on the elderly. Early referral to a doctor avoids all these risks, in all cases the pathological diagnosis was nodular BCCs. The aesthetic and functional outcomes were good to very good, and the patients reported being highly satisfied. Full article