Lacrimal gland prolapse in blepharochalasis

Hundal, K S; Mearza, Ali; Joshi, Naresh

doi:10.1038/sj.eye.6700668

Cited by 13 publications

(5 citation statements)

References 6 publications

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“…They had similar findings in that two-thirds of these patients had focal lymphocytic change and the other third had no pathological changes. 12 Hundal et al 3 published a case report where lacrimal gland prolapse was identified preoperatively in a patient with blepharochalasis. Tissue biopsy of the lacrimal gland performed intraoperatively identified chronic inflammatory infiltration.…”

Section: Discussionmentioning

confidence: 99%

“…Tissue biopsy of the lacrimal gland performed intraoperatively identified chronic inflammatory infiltration. 3 Xin et al 13 reported histopathological findings in 23 patients with lacrimal gland prolapse and blepharochalasis. Changes identified included inflammatory infiltration, elastic fiber degeneration, marked loosening of the supporting fascia tissue, and an increased level of immunocytes.…”

Section: Discussionmentioning

confidence: 99%

“…Lacrimal gland prolapse is an acquired clinical condition that is primarily caused by the relaxation of the local suspending ligaments or weakness of the orbital septum, as seen with age or following trauma. 1,2 This condition has been associated with dermatochalasis, 2 blepharochalasis, 3,4 and occult orbital fat herniation. 5 Although it is a clinical diagnosis, it can occasionally cause diagnostic uncertainty given that other systemic conditions present with a lateral upper eyelid mass.…”

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confidence: 99%

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Histopathological Characteristics of Lacrimal Gland Prolapse

Huang

Juniat

James

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: Lacrimal gland prolapse is an acquired clinical condition that can present as an upper eyelid mass. Patients may undergo lacrimal gland biopsy when there is diagnostic uncertainty. We aim to describe the histopathological features of this patient group. Methods: Retrospective case series involving 11 patients. Results: The mean age at presentation was 52.3 ± 16.2 years (range: 31–77 years) with 8 patients (72.3%) being female. The most common presenting symptom was a palpable mass (9; 81.8%) followed by dermatochalasis (4; 36.4%). Three cases (27.3%) were bilateral. Common imaging findings include lacrimal gland enlargement and visualization of the prolapse. All biopsies demonstrated features of mild chronic inflammation with preserved glandular structures. Ten patients (90.9%) underwent surgical intervention involving lacrimal gland pexy and 1 patient (9.1%) was elected for observation only. One patient required repeat surgery after 4 years due to recurrence of symptoms. At the last follow-up, all patients had stable disease or complete resolution of symptoms. Conclusion: We present a case series of patients diagnosed with lacrimal gland prolapse who underwent a biopsy during their workup. All biopsies demonstrated features of mild chronic inflammation (dacryoadenitis). All patients had stable disease or complete resolution of symptoms. This case series suggests that chronic inflammation is a common finding in patients with lacrimal gland prolapse but bears minimal clinical consequence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Histopathological Characteristics of Lacrimal Gland Prolapse

Huang

Juniat

James

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…Macroscopically, the prolapsed lacrimal tissue resembles hypertrophied fat, which can lead to an inadvertent lacrimal resection during blepharoplasty, with subsequent aqueous tear deficiency and resultant damage to the surface of the eye. 34,35 MC-MR imaging evaluation of palpebral swelling can alert ophthalmic surgeons to this diagnosis, as was the case in Fig 4, and help avoid inadvertent lacrimal gland resection.…”

Section: Lacrimal Gland Prolapsementioning

confidence: 95%

MR-Eye: High-Resolution Microscopy Coil MRI for the Assessment of the Orbit and Periorbital Structures, Part 2: Clinical Applications

Dobbs

Budak

White

et al. 2021

AJNR Am J Neuroradiol

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In the first part of this 2-part series, we described how to implement microscopy coil MR imaging of the orbits. Beyond being a useful anatomic educational tool, microscopy coil MR imaging has valuable applications in clinical practice. By depicting deep tissue tumor extension, which cannot be evaluated clinically, ophthalmic surgeons can minimize the surgical field, preserve normal anatomy when possible, and maximize the accuracy of resection margins. Here we demonstrate common and uncommon pathologies that may be encountered in orbital microscopy coil MR imaging practice and discuss the imaging appearance, the underlying pathologic processes, and the clinical relevance of the microscopy coil MR imaging findings.

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“…17 The correction of lacrimal gland ptosis has already been described by several authors in the literature. 3,9,[12][13][14][18][19][20][21][22][23][24][25][26][27] However, most of these series found are small and there is no literature review that compiles and synthesizes their results and possible complications.…”

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confidence: 99%

Correction of Lacrimal Gland Ptosis in Blepharoplasty: A Systematic Review

Chavarino

Cerdá

Magallón

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: Lacrimal gland ptosis has a prevalence of 10% to 15% in Caucasian patients, reaching up to 60% in older age. Its involuntary resection during blepharoplasty carries the potential risk of compromising corneal lubrication. The purpose of this systematic review is to check whether there is a consensus in the literature regarding the surgical procedure of choice and which outcomes and complications have been observed.Methods: A systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A search was carried out in the Medline, Scopus, and Cochrane databases in March 2022.Results: A total of 16 studies involving 483 patients with lacrimal gland ptosis have been included. In 90.06% of patients, resuspension or direct refixation of the gland to the lacrimal fossa with suture to the orbital periosteum was performed. Follow up has been inconsistent, with an average of 18 months. Regarding complications, 5 recurrences and only 2 patients with persistent dry eye were observed.Conclusions: In general, the evidence is sparse. Nevertheless, repair of lacrimal gland ptosis is a relatively simple, reproducible, and safe surgical technique, with a low likelihood of recurrence, severe, or persistent complications. A classification is proposed for both the grading of ptosis and its treatment.

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Lacrimal gland prolapse in blepharochalasis

Abstract: Blepharochalasis is an uncommon disorder that sometimes requires surgical management in the form of blepharoplasty. We present such a case with an unexpected perioperative finding of lacrimal gland prolapse.Case report

Cited by 13 publications

References 6 publications

Histopathological Characteristics of Lacrimal Gland Prolapse

Histopathological Characteristics of Lacrimal Gland Prolapse

MR-Eye: High-Resolution Microscopy Coil MRI for the Assessment of the Orbit and Periorbital Structures, Part 2: Clinical Applications

Correction of Lacrimal Gland Ptosis in Blepharoplasty: A Systematic Review

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