BACKGROUND: Breast ptosis is characterized by severe volumetric deficiency of the upper pole, excess of skin in the lower pole and descent of the nipple-areola complex (NAC). Mastopexy, also known as breast lifting, is the surgical operation aimed to reshape the ptotic breast. Recurrence of breast ptosis after mastopexy is common but to the best of our knowledge no study before has measured it. PURPOSE: The aim of this study was to measure the recurrence of breast ptosis after mastopexy in a prospective study. MATERIALS AND METHODS: Female patients affected by unilateral or bilateral moderate or severe breast ptosis were enrolled in the study. All the patients underwent mastopexy performed only with the removal of skin excess following a Wise pattern. The jugular notch-nipple distance was measured before surgery, immediately after surgery and after 1, 3, 6 and 12 months. RESULTS: Ten patients were included in the study, four underwent unilateral mastopexy and six underwent bilateral mastopexy. The lifting of the NAC, measured in the immediate post-operative period, ranged from 3 to 8.5 cm, with an average value of 6.3 cm. This lifting, one year after surgery, ranged from 2 to 7 cm, with an average value of 4.6 cm. The percentage loss of the NAC lifting one year after surgery compared to the immediate post-operative time ranged from 12.5 to 41.7%, with an average value of 27.5%. CONCLUSION: In our case series, the lifting of the NAC obtained immediately after surgery showed an average loss of 27.5% one year after surgery. Even if limited by the low number of patients included, this pilot study is eye-opening on a very common phenomenon that occurs after mastopexy. The patients should be informed about the possible recurrence of the breast ptosis.

• Klíčová slova
• body contouring surgery, breast ptosis recurrence, breast ptosis treatment outcomes, breast surgery, mastopexy,
• MeSH
• blefaroptóza * chirurgie   MeSH
• lidé MeSH
• mamoplastika * škodlivé účinky   MeSH
• následné studie MeSH
• pilotní projekty MeSH
• prospektivní studie MeSH
• prsní bradavky chirurgie   MeSH
• prsy chirurgie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: ptosis is anomalous drop of the upper eyelid. Depending on the cause of the state and especially according to the results of clinical findings (dominated significance of elevation of the upper eyelid) we can be perform various surgical procedures. Operation under Fasanella-Servat is suitable for the easiest cases - function of the upper eye-lid levator muscle (levator) is at least 10 mm and a maximum of 2 mm ptosis. Aponeurosis advancement has good results in all types of involutional origin. Eyelid levator resection is performed when the levator function is better than 5 mm. Eye-lid sling to brow lift mechanism is designed for the toughest conditions, when the levator function is worse than 4 mm. The authors present the results of surgery for ptosis with biocompatible PVC tube fronto-tarsal sling. METHODS: case-reports of 4 eyes in 3 adult patients were prospectively monitored. It was a one man and two women with different etiologies of ptosis. The principle of operation is suspension the upper eyelid to eyebrow-levators using PVC tubes in the subcutaneous tissue. Monitored parameters were: best corrected visual acuity, clinical finding of the front segment (with an emphasis on lagophthalmos in the postoperative period), eye-fissure height and levator function in millimeters (mm). RESULTS: there was the most severe degree of ptosis in all cases. In terms of functional and cosmetic effect treatment were surgeries successful in all patients. One half of the cases (2 of 4 eyes) had transient postoperative lagophtalmos, which in one case was solved with moisture chamber. None of exposure keratopathy developed. In one case, it was after 9 months after the operation, we had to extract one implant due to extruzion of the tube. CONCLUSIONS: The fronto-tarsal tubing with biocompatible PVC is effective and relatively safe technique in cases of severe degree of ptosis of the upper eyelid. The material appears to be well tolerated by the surrounding tissue.

• MeSH
• biokompatibilní materiály * MeSH
• blefaroplastika metody   MeSH
• blefaroptóza chirurgie   MeSH
• dospělí MeSH
• lidé MeSH
• oční víčka chirurgie   MeSH
• polyvinylchlorid * MeSH
• prospektivní studie MeSH
• protézy - design MeSH
• protézy a implantáty * MeSH
• senioři nad 80 let MeSH
• zraková ostrost MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• biokompatibilní materiály * MeSH
• polyvinylchlorid * MeSH

UNLABELLED: The aim is to report a rare complication of surgical ptosis correction in a patient with Kearns Sayre syndrome and the therapeutic possibilities of its treatment. METHODS: Exposure corneal ulceration caused by lagophtalmos developed gradually in a 30-year-old woman after an upper eyelid ptosis surgery of the right eye performed at another eye clinic. During an examination a limited movement of both eyes and retinal pigmentary changes (salt-pepper-like appearance) were diagnosed. A suspicion of the Kearns Sayre syndrome was expressed according to the clinical picture, the diagnosis was confirmed by molecular analyses in muscle biopsy, which revealed 5.2 kb deletion of mitochondrial DNA. RESULTS: Corneal ulceration was treated by partial external tarsorrhaphy and frequent instillation of lubricants. The upper eyelid ptosis of the left eye was treated with a spectacle with ptosis support. CONCLUSION: During the correction of upper eyelid ptosis in patients with progressive external ophtalmoplegia it is necessary to be aware of the risk of surgical exposure keratopathy and corneal ulceration due to the atony of musculus orbicularis oculi muscle and only slightly expressed Bell's phenomenon.

• MeSH
• blefaroptóza komplikace   chirurgie   MeSH
• dospělí MeSH
• Kearnsův-Sayreův syndrom komplikace   MeSH
• lidé MeSH
• pooperační komplikace * MeSH
• vřed rohovky etiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• kazuistiky MeSH

• MeSH
• amblyopie etiologie   MeSH
• blefaroptóza chirurgie   MeSH
• dítě MeSH
• lidé MeSH
• nemocniční oddělení MeSH
• oftalmologie MeSH
• pooperační komplikace MeSH
• předškolní dítě MeSH
• věkové faktory MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Československo MeSH

AIM: A systematic review of surgical procedures on eyelids and the conjunctival sac in the case of instability of an ocular prosthesis from the author's own experience. MATERIAL AND METHODS: In a prospective follow-up conducted from March 2022 to July 2024, the study comprised 51 patients with an unstable prosthesis who were referred by a prosthetist. The study examined the demographic data, cause of enucleation of the eyeball, the time interval between the onset of prosthesis instability and the surgical procedure of enucleation, and the surgical methods of correction to provide functional and aesthetic improvement. RESULTS: The 49 patients included 13 women with a mean age of 61.4 years (39-78) and 36 men with a mean age of 56.3 years (22-82). The most common causes of enucleation were trauma and malignant melanoma. The time interval from surgery/enucleation was 24.4 years for trauma etiology. After enucleation for malignant melanoma, the time interval was 4.2 years. In the 49 patients, 61 surgical procedures were performed to improve stability of the prosthesis. Lateral tarsorrhaphy was performed in 10 cases, 4 of which were combined with an orbital periosteal sling. Horizontal shortening of the lower eyelid was performed in 24 cases, 18 times separately and 6 times in combination with another procedure on the lower eyelid. Upper eyelid droop surgery was performed 8 times, including 5 times separately. Surgery for increasing the volume of the conjunctival sac with amniotic membrane transplantation was performed in 17 cases, 7x separately and 9x in combination with procedures on the lower eyelid . 44 patients underwent 1 surgical procedure, 4 patients underwent 2 procedures, and 3 patients underwent 3 procedures. Three patients also underwent hyaluronic acid injection to supplement the volume of the conjunctival sac. Cosmetically, the result and stability of the ocular prosthesis was achieved in 47 patients out of 49, 2 patients did not attend further procedures. CONCLUSION: Conjunctival sac changes with instability of the ocular prosthesis have a significant functional and psychological consequences. The causes of instability are varied, which influences the choice of surgical procedures. The surgical procedures presented in this paper may be effective separately, or a combination of them may be required.

• Klíčová slova
• amniotic membrane transplantation, conjunctival sac contracture, horizontal shortening of the lower eyelid, upper eyelid ptosis surgery,
• MeSH
• anoftalmie chirurgie   MeSH
• dospělí MeSH
• enukleace oka MeSH
• konjunktiva chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• oční protézy * MeSH
• oční víčka chirurgie   MeSH
• prospektivní studie MeSH
• selhání protézy MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• zákroky plastické chirurgie metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• systematický přehled MeSH

Congenital divided melanocytic nevi of the upper and lower eyelid are rare pigmented changes of the eyelids. These processes are also known as "kissing nevi," "panda nevi," and "split ocular nevi," and were first described by Fuchs in 1919. About 120 cases have been described in the literature so far. Congenital melanocytic nevi are either present at birth (small nevi are already found in about 1% of neonates) or manifest predominantly during the first decade of life. These rare melanocytic changes of the eyelids should be controlled regularly, as malignant transformation can occur. The actual incidence of malignant transformation is highly variable in the literature, ranging from 2 to 40% depending on the duration of follow-up, with an average of 14% for the whole lifetime. Moreover, nevi of the eyelids may be considered cosmetically disturbing and cause functional problems. Therapeutic removal (dermabrasion, cryotherapy, laser therapy, and surgical excision with ophthalmoplastic reconstruction) is rarely medically indicated due to the low risk of malignant transformation. Removal can be performed in cases of secondary amblyopia in ptosis, compression of the lacrimal point, epiphora, or cosmetic desire. Treatment becomes necessary not only in case of suspicious manifestation or impairment of eyelid function, but it also helps to avoid possible bullying at school among children and is recommended at age 4 to 6 (before school age).

Kongenitale geteilte melanozytäre Nävi (CMN) des Ober- und Unterlids sind seltene pigmentierte Veränderungen der Augenlider. Diese Muttermale sind auch als „kissing nevi“, „panda nevi“, „split ocular nevi“ bekannt und wurden erstmals 1919 von Fuchs beschrieben. Aus der Literatur sind bisher etwa 120 solcher Fälle bekannt. CMN sind entweder seit der Geburt vorhanden (kleine Nävi finden sich bereits bei ca. 1 % der Neugeborenen), oder sie manifestieren sich überwiegend im ersten Lebensjahrzehnt. Diese seltene melanozytäre Veränderung der Augenlider sollte regelmäßig kontrolliert werden, denn gemäß der Literatur kann es zu einer malignen Entartung kommen. Die tatsächliche Inzidenz dafür ist jedoch sehr variabel und reicht von 2 bis 40 %, je nach Dauer des Follow-up, mit durchschnittlich 14 % auf die gesamte Lebensdauer. Zudem können CMN an den Augenlidern als kosmetisch störend empfunden werden und zu funktionellen Problemen des Auges führen. Eine therapeutische Entfernung mittels Dermabrasion, Kryotherapie, Laserbehandlung oder chirurgische Exzision mit ophthalmoplastischer Deckung ist aufgrund des geringen Entartungsrisikos selten medizinisch indiziert. Sie kann aber bei sekundärer Amblyopie bei Ptosis, Kompression der Puncta lacrimalia, Epiphora oder basierend auf einem kosmetischen Wunsch durchgeführt werden. Notwendig wird die Therapie hingegen bei einer suspekten Erscheinungsform oder Beeinträchtigung der Lidfunktion und um mögliche Hänseleien und grausamen Spott bei Kindern zu vermeiden.

• Klíčová slova
• Congenital divided melanocytic nevi, Malignant transformation, Nonsurgical management, Regenerative medicine, Surgical management,
• MeSH
• dítě MeSH
• epiteloidní a vřetenobuněčný névus * chirurgie   MeSH
• laserová terapie * MeSH
• lidé MeSH
• nádorová transformace buněk patologie   MeSH
• nádory kůže * chirurgie   MeSH
• novorozenec MeSH
• oční víčka chirurgie   MeSH
• pigmentový névus * chirurgie   MeSH
• předškolní dítě MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH

The authors analyzed medical records of 1644 surgeries of strabismus and ptosis performed during the ten-years period (1997-2006). The surgeries were divided into three groups according to the age of the patients: 531 surgeries were performed in patients until the age of 6 years, 508 surgeries were in children aged 7-18 years, and the study included also 605 operative procedures in adult patients aged 19 years and older. The strabismus operations formed 1401 single or multi-phases surgeries and the ptosis correction was performed in 243 patients. The most common surgical procedures in strabismus were weakening or strengthening procedures on the horizontal muscles (65 %). Out of the weakening procedures, the authors positively preferred the adjustable partial myotomy acc. Gonin-Hollwich, which formed 51 % of surgeries on horizontal muscles. The very favorable results underlined the importance of this type of surgery in congenital esotropia, Duane syndrome I., and in excess of divergence. This surgical technique was also used as a weakening procedure as a part of the Kestenbaum procedure in the treatment of torticollis in horizontal nystagmus. The solely surgery on oblique or vertical muscles was performed in 16 %, and the most common operative procedure was the retro-position of the lower oblique muscle acc. to Parkes, and on the second place, there was its partial myotomy with electro-cautery acc. to Romer-Martinez. The weakening procedures were used together on the horizontal and oblique muscles in 10 %. Different surgical procedures, including the transposition's ones, were indicated in external ocular muscles palsies and torticollis. Altogether they formed 12 % of all strabismus surgeries. The most common procedure to treat the ptosis in children and teenagers was the fronto-tarsal suspension acc. to Fox (51 %), and in adults, it was the tarso-resection of the upper eyelid acc. to Fasanella (74 %).

• MeSH
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• poruchy hybnosti oka chirurgie   MeSH
• předškolní dítě MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• předškolní dítě MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

Ectopic cilia are extremely rare congenital anomalies in which eyelash follicles appear in an abnormal place on the eyelid, most typically on the lateral quadrant of the anterior surface of the upper eyelid. In the majority of cases, simple surgical excision of ectopic cilia is indicated because of its cosmetic aspect. There is usually no associated medical co-morbidity with this anomaly. The authors report an unusual case of ectopic cilia associated with an orbital dermoid cyst and sinus tract. A 3-year-old boy was initially diagnosed with ectopic cilia on the left upper eyelid. There was no history of inflammation or swelling of the eyelid. An ophthalmological examination revealed only 1 mm of ptosis; no proptosis, inferior displacement, or palpable orbital mass was present. During surgical excision of the ectopic cilia, a thin sinus tract was identified, leading posteriorly to the orbit. Magnetic resonance imaging performed after the excision showed a supraorbital extraconal mass just below the roof of the left orbit. A supraorbital 2-piece craniotomy was performed with total extirpation of the dermoid cyst. The cyst was removed en bloc without damage to the extraocular muscles, but the sinus tract could no longer be identified. Follow-up MRI was performed 6 months after surgery and showed no evidence of recurrence. A follow-up ophthalmological examination showed no signs of inferior displacement or proptosis. To the best of the authors' knowledge, this case is the first reported instance of ectopic cilia associated with a dermoid cyst and sinus tract in which no typical clinical signs and symptoms of possible orbital pathology were present. This case highlights the value of radiological examination in all cases of ectopic cilia prior to surgical excision.

• Klíčová slova
• congenital, dermoid cyst, ectopic cilia, orbit, sinus tract,
• MeSH
• choristom komplikace   chirurgie   MeSH
• cilie * MeSH
• dermoidní cysta diagnóza   chirurgie   MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• nádory orbity komplikace   diagnóza   chirurgie   MeSH
• píštěle komplikace   chirurgie   MeSH
• předškolní dítě MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH