RESUMEN
The cryoprobe device is commonly used by orbital surgeons for the extraction of intraorbital lesions. Cryoprobes provide a safe mechanism to manipulate fluid-filled tumors. Such lesions can present in locations in which intraoperative neurosurgical assistance is essential. The authors describe a technique whereby removal of an orbital hemangioma was facilitated by the aid of an endoscopic, transnasal cryoprobe while standard microsurgical dissection was performed concurrently via a transconjunctival approach.
Asunto(s)
Craneotomía/métodos , Criocirugía/métodos , Endoscopía/métodos , Hemangioma Cavernoso del Sistema Nervioso Central/cirugía , Cavidad Nasal/cirugía , Neoplasias Orbitales/cirugía , Craneotomía/instrumentación , Criocirugía/instrumentación , Endoscopía/instrumentación , Femenino , Hemangioma Cavernoso del Sistema Nervioso Central/diagnóstico por imagen , Humanos , Persona de Mediana Edad , Órbita/cirugía , Neoplasias Orbitales/diagnóstico por imagen , Radiografía , Resultado del TratamientoRESUMEN
OBJECTIVE: To report the first case of gaze-evoked amaurosis secondary to an intraocular foreign body and to highlight the characteristic clinical findings of patients with this symptom. DESIGN: Case report and review of the literature. METHODS: Case review, clinical history, electrophysiologic testing, and follow-up. MAIN OUTCOME MEASURES: Visual acuity, automated perimetry, and visual fields. RESULTS: A case of gaze-evoked amaurosis as a result of an intraorbital foreign body is described, and 19 additional cases of gaze-evoked amaurosis are reviewed from the English language literature. These cases share certain characteristics including good vision in primary position with deterioration of vision in eccentric gaze; concurrent objective pupillary abnormalities in eccentric gaze; stereotypic onset and recovery of vision; and funduscopic abnormalities consisting of disc edema and chorioretinal folds. CONCLUSIONS: Gaze-evoked amaurosis is a reliable sign of intraconal mass lesion. We report the first case of gaze-evoked amaurosis secondary to an intraorbital foreign body.
Asunto(s)
Ceguera/etiología , Cuerpos Extraños en el Ojo/complicaciones , Lesiones Oculares Penetrantes/complicaciones , Movimientos Oculares , Órbita/lesiones , Heridas por Arma de Fuego/complicaciones , Cuerpos Extraños en el Ojo/diagnóstico por imagen , Lesiones Oculares Penetrantes/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Órbita/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Agudeza Visual , Pruebas del Campo Visual , Campos Visuales , Heridas por Arma de Fuego/diagnóstico por imagenRESUMEN
A 32-year-old woman noted left lid retraction during pregnancy. Examination revealed unilateral enophthalmos without symptoms of diplopia or sinus disease. Orbital imaging showed characteristic features of the silent sinus syndrome, which were confirmed intraoperatively. The clinical and imaging attributes of this syndrome are discussed, including possible mechanisms of disease development. Management strategies are summarized. A brief discussion of the differential diagnosis of enophthalmos is also included.
Asunto(s)
Enoftalmia/etiología , Párpados/patología , Sinusitis Maxilar/complicaciones , Complicaciones del Embarazo , Adulto , Diagnóstico Diferencial , Endoscopía/métodos , Enoftalmia/diagnóstico , Enoftalmia/cirugía , Femenino , Humanos , Imagen por Resonancia Magnética , Sinusitis Maxilar/diagnóstico , Sinusitis Maxilar/cirugía , Embarazo , Tomografía Computarizada por Rayos XRESUMEN
A 51-year-old woman with hyperthyroidism presented with a 4-week history of bilateral progressive visual loss despite treatment with oral prednisone. Her visual function improved after bilateral orbital decompression. The indications for and advantages and disadvantages of radiation therapy and orbital decompression in TAO are discussed. The management of intraocular pressure, strabismus, and lid abnormalities in TAO is also addressed.
Asunto(s)
Ceguera/etiología , Enfermedad de Graves/complicaciones , Oftalmoplejía/etiología , Ceguera/diagnóstico , Ceguera/terapia , Descompresión Quirúrgica , Progresión de la Enfermedad , Endoscopía , Femenino , Glucocorticoides/uso terapéutico , Enfermedad de Graves/diagnóstico , Enfermedad de Graves/terapia , Humanos , Persona de Mediana Edad , Oftalmoplejía/diagnóstico , Oftalmoplejía/terapia , Órbita/diagnóstico por imagen , Órbita/cirugía , Prednisona/uso terapéutico , Tomografía Computarizada por Rayos X , Agudeza Visual , Pruebas del Campo Visual , Campos VisualesRESUMEN
This year's review of enucleation, evisceration, and sympathetic ophthalmia yielded a multitude of studies and data. Articles ranged from single case reports to large clinical series and in-depth subject overviews. With regard to enucleation, several new HA implant variations were described, along with limited clinical experience. Various techniques for management of postenucleation and evisceration complications also were described, including management of infection, implant exposure, and postenucleation socket syndrome. The risk of sympathetic ophthalmia after evisceration, as compared with enucleation, remains a highly polarized and inconclusive subject.
Asunto(s)
Enucleación del Ojo/efectos adversos , Evisceración del Ojo/efectos adversos , Oftalmía Simpática/etiología , Humanos , Implantes Orbitales/efectos adversos , Ajuste de Prótesis , Factores de RiesgoRESUMEN
A 48-year-old man presented to the emergency department with a 3-day history of decreased vision in a painful proptotic right eye. The patient was being treated with chemotherapy and radiation for non-small cell lung carcinoma. Examination showed visual acuity of hand motions, decreased motility, and an afferent pupillary defect on the right, consistent with an orbital apex syndrome. Neuroimaging revealed "dirty" orbital fat and no paranasal sinus disease. Orbital biopsy initially showed only fibrosis; however, on subsequent biopsies, nonseptate hyphae later identified as mucormycosis was recovered. The patient survived with exenteration and systemic amphotericin B.
Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/complicaciones , Exoftalmia/etiología , Infecciones Fúngicas del Ojo/complicaciones , Neoplasias Pulmonares/complicaciones , Mucormicosis/complicaciones , Enfermedades Orbitales/complicaciones , Baja Visión/etiología , Anfotericina B/uso terapéutico , Antifúngicos/uso terapéutico , Biopsia , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Diagnóstico Diferencial , Exoftalmia/diagnóstico , Exoftalmia/tratamiento farmacológico , Infecciones Fúngicas del Ojo/diagnóstico , Infecciones Fúngicas del Ojo/tratamiento farmacológico , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/tratamiento farmacológico , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Mucormicosis/diagnóstico , Mucormicosis/tratamiento farmacológico , Enfermedades Orbitales/diagnóstico , Enfermedades Orbitales/tratamiento farmacológico , Tomografía Computarizada por Rayos X , Baja Visión/diagnóstico , Baja Visión/tratamiento farmacológicoRESUMEN
OBJECTIVE: The authors evaluated a new design of a conical-shaped enucleation implant to help minimize the occurrence of superior sulcus defects and maximize motility of the prosthesis. The implant shape is a modification of a sphere. It has a posterior conical projection paralleling the orbital walls, a superior projection supporting the soft tissues of the upper eyelid sulcus, a flattened anterior surface, and channels for each rectus muscle. DESIGN: The study design was a consecutive case series from the Oculoplastics and Orbital Service of the Massachusetts Eye and Ear Infirmary. INTERVENTION/PARTICIPANTS: A total of 45 patients (average age, 40 years; range, 13-75 years) had placement of a conical implant (39 primary enucleations, 6 secondary implants) with a minimum of 1 year' follow-up (range, 12-36 months). All of the primary enucleations and two of the secondary procedures had the anterior portion of the implant covered with autologous fascia. Four of the secondary implants were covered with pseudocapsule harvested from the explanted primary implant. Prostheses were fit 6 to 10 weeks after surgery. MAIN OUTCOME MEASURES: Postoperative appearance of patients was assessed by qualitative appearance of the superior sulcus and prosthetic motility, and subjectively by patients' satisfaction. RESULTS: A total of 43 patients had minimal or no superior sulcus defect, whereas 2 patients had moderate defects. There were no severe sulcus defects. All patients were satisfied with their appearance and did not seek further surgery to correct any upper sulcus asymmetry. Prosthetic motility with small-angle ductions (<10 degrees) and saccades was good in all cases. There were two cases of conjunctival wound dehiscence. Both occurred within 4 weeks of surgery. One wound dehiscence was sutured, whereas the other healed spontaneously. There were no cases of implant extrusion, migration, or infection. CONCLUSION: The conical orbital implant provides appropriate reconstitution of orbital volume while minimizing superior sulcus defects with adequate prosthetic motility.
Asunto(s)
Enucleación del Ojo , Movimientos Oculares/fisiología , Órbita/cirugía , Satisfacción del Paciente , Polietilenos , Prótesis e Implantes , Adolescente , Adulto , Anciano , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Órbita/anatomía & histología , Órbita/diagnóstico por imagen , Complicaciones Posoperatorias , Diseño de Prótesis , Implantación de Prótesis , Procedimientos de Cirugía Plástica , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
OBJECTIVE: To evaluate the outcome of extracranial optic nerve decompression in patients with compressive optic neuropathy secondary to intracranial, paranasal sinus, or orbital neoplastic processes. DESIGN: A retrospective chart review and clinical follow-up of patients who underwent optic nerve decompression. SETTING: Tertiary care referral center. PATIENTS: During an 8-year period, 95 extracranial optic nerve decompressions were performed by one of us (M.P.J.) for optic neuropathy resulting from traumatic, inflammatory, infectious, iatrogenic, neoplastic, and idiopathic processes. Thirty patients with compressive optic neuropathy secondary to histopathologically confirmed tumors were identified. INTERVENTION: Optic nerve decompression via external ethmoidectomy approach. RESULTS: Twenty (67%) of 30 patients showed improvement in vision. Improvement in 17 of the 20 patients has been stable. Seven patients (23%) showed no improvement but there was no further worsening of vision after surgery. In 3 patients (10%) vision deteriorated following surgery. CONCLUSION: Extracranial optic nerve decompression may be considered for the preservation or improvement of vision in selected patients with compressive optic neuropathy from neoplasms.
Asunto(s)
Neoplasias de Cabeza y Cuello/complicaciones , Síndromes de Compresión Nerviosa/etiología , Síndromes de Compresión Nerviosa/cirugía , Enfermedades del Nervio Óptico/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Síndromes de Compresión Nerviosa/fisiopatología , Estudios Retrospectivos , Agudeza VisualRESUMEN
In a case of traumatic avulsion of the optic nerve at the anterior chiasm, MR imaging provided highly specific images of the injury site, including the absence of the optic nerve within the optic canal and the point of transection at the anterior portion of the chiasm. This was confirmed clinically and histopathologically. MR imaging should be considered in cases of suspected chiasmal injury.
Asunto(s)
Lesiones Oculares Penetrantes/diagnóstico , Imagen por Resonancia Magnética , Quiasma Óptico/lesiones , Traumatismos del Nervio Óptico , Tomografía Computarizada por Rayos X , Adulto , Dominancia Cerebral/fisiología , Exoftalmia/diagnóstico , Exoftalmia/patología , Exoftalmia/cirugía , Lesiones Oculares Penetrantes/patología , Lesiones Oculares Penetrantes/cirugía , Humanos , Masculino , Músculos Oculomotores/lesiones , Músculos Oculomotores/patología , Músculos Oculomotores/cirugía , Quiasma Óptico/patología , Quiasma Óptico/cirugía , Nervio Óptico/patología , Nervio Óptico/cirugía , Degeneración Retrógrada/fisiología , Agudeza Visual/fisiología , Campos Visuales/fisiologíaRESUMEN
Both classic descriptions and new findings in human anatomy have been limited in the past to cadaveric dissections. Although dissection still supplies most of new information, refinements in technique and the advent of high-resolution soft tissue imaging available with magnetic resonance have certainly provided a new perspective on our understanding of anatomy. In this review, the most recent descriptions of periocular and orbital anatomy will be discussed, along with comments on their clinical implications.
Asunto(s)
Párpados/anatomía & histología , Órbita/anatomía & histología , Párpados/irrigación sanguínea , Humanos , Imagen por Resonancia Magnética , Órbita/irrigación sanguíneaRESUMEN
Aneurysmal bone cyst is a rare but recognized osseous lesion of the orbit. We report the presentation, treatment, and postoperative course of an orbital aneurysmal bone cyst in a patient with McCune-Albright syndrome. To our knowledge, this report represents the first description of aneurysmal bone cyst of the orbit in a patient with fibrous dysplasia. Although visual loss in patients with fibrous dysplasia is most commonly due to narrowing of the optic canal, aneurysmal bone cyst should be considered in a patient with fibrous dysplasia who presents with decreasing vision in the face of a rapidly expanding orbital mass. The treatment in this case was drainage and debridement with prompt resolution. Although not necessary in this case, an alternative treatment includes packing with bone chips. Radiation is usually avoided because of the risk of iatrogenically induced sarcoma.
Asunto(s)
Quistes Óseos Aneurismáticos/complicaciones , Displasia Fibrosa Poliostótica/complicaciones , Enfermedades Orbitales/complicaciones , Adulto , Quistes Óseos Aneurismáticos/diagnóstico por imagen , Quistes Óseos Aneurismáticos/patología , Quistes Óseos Aneurismáticos/cirugía , Humanos , Masculino , Enfermedades Orbitales/diagnóstico por imagen , Enfermedades Orbitales/patología , Enfermedades Orbitales/cirugía , Tomografía Computarizada por Rayos XAsunto(s)
Malformaciones Arteriovenosas/diagnóstico por imagen , Síndromes de Compresión Nerviosa/diagnóstico por imagen , Enfermedades del Nervio Óptico/diagnóstico por imagen , Órbita/irrigación sanguínea , Tomografía Computarizada por Rayos X/métodos , Adulto , Malformaciones Arteriovenosas/cirugía , Hemorragia/diagnóstico por imagen , Hemorragia/cirugía , Humanos , Masculino , Síndromes de Compresión Nerviosa/cirugía , Enfermedades del Nervio Óptico/cirugía , Complicaciones Posoperatorias/diagnóstico por imagen , Maniobra de Valsalva , Presión Venosa/fisiologíaRESUMEN
BACKGROUND: Upper eyelid retraction in Graves disease may cause functional morbidity and aesthetic deformity. Surgery to correct thyroid-related upper eyelid retraction may result in temporal undercorrection with failure to eliminate lateral eyelid retraction, leading in turn to a poor eyelid contour postoperatively. METHODS: In 1984, one of the authors developed a new procedure for correcting moderate to severe upper eyelid retraction associated with Graves disease. The surgical technique consists of a Müllerotomy and recession of the levator aponeurosis combined with medial transposition of the lateral horn of the levator aponeurosis. The procedure was performed on 37 patients (72 eyelids). Müller's muscle was used as the spacer to set the eyelid height. Transposition of the levator aponeurosis allowed adjustment of eyelid contour. RESULTS: Thirty patients (58 eyelids) had excellent results, six (13 eyelids) had good results, and one (1 eyelid) had a poor result. No patient required re-operation for asymmetry, unacceptable contour, or malposition. Only one eyelid had significant overcorrection, and only one eyelid had significant undercorrection, requiring further surgery. The most frequent unwanted effects were high eyelid crease (24 eyelids) and residual temporal flare (6 eyelids); however, most of these were seen early in the series before the lateral levator transposition modification was added. CONCLUSION: This procedure allows successful and simultaneous correction of both eyelid position and contour in patients with moderate to severe thyroid-related upper eyelid retraction.
Asunto(s)
Enfermedades de los Párpados/cirugía , Párpados/cirugía , Músculos Faciales/cirugía , Enfermedad de Graves/complicaciones , Músculos Oculomotores/cirugía , Adulto , Enfermedades de los Párpados/etiología , Párpados/inervación , Femenino , Humanos , Transferencia de Nervios/métodos , Pronóstico , Transferencia Tendinosa/métodosRESUMEN
Diplopia is a prominent finding in patients who have suffered orbital fractures. If the patient's double vision or ocular motility restriction was caused by soft tissue entrapment into the fracture site, surgery is frequently performed in order to release this entrapment and restore normal eye movement. However, the presence of diplopia should not necessarily be an indication for surgery. Brief case reports are hereby presented to illustrate that the symptoms of diplopia and motility restriction are not always attributable to the presence of orbital fractures that require surgical repair. The purpose of this article is to describe other causes of abnormal ocular motility that are associated with orbital trauma but which are not caused by soft tissue entrapment.
Asunto(s)
Trastornos de la Motilidad Ocular/etiología , Fracturas Orbitales/complicaciones , Traumatismo del Nervio Abducente/etiología , Adulto , Anciano , Niño , Contusiones/etiología , Diagnóstico Diferencial , Diplopía/etiología , Síndrome de Retracción de Duane/complicaciones , Edema/etiología , Movimientos Oculares , Femenino , Enfermedad de Graves/complicaciones , Humanos , Masculino , Enfermedades Musculares/etiología , Miastenia Gravis/complicaciones , Trastornos de la Motilidad Ocular/diagnóstico , Músculos Oculomotores/lesiones , Músculos Oculomotores/fisiopatología , Traumatismos del Nervio Oculomotor , Oftalmoplejía/diagnóstico , Oftalmoplejía/etiología , Fracturas Orbitales/cirugía , Prolapso , Traumatismos de los Tendones/etiología , Traumatismos del Nervio Troclear , Campos VisualesRESUMEN
BACKGROUND: There has been growing interest in using porous alloplastic implants for reconstructive orbital surgery because of their perceived increased biocompatibility. One commercially available porous implant is high-density porous polyethylene (Medpor). It is made of pure particles of polyethylene that form interconnecting pores and have excellent handling characteristics. METHODS: The authors performed 37 orbital reconstructions using 0.85-, 1.5-, or 3-mm porous polyethylene sheets to reconstruct internal orbital defects. Mean postoperative follow-up was 18.5 months. Four patients were treated for anophthalmic enophthalmos; there was one patient with spontaneous enophthalmos. In selected patients, other implants also were used, including miniplates or microplates, silastic sheets, autologous bone, or nasal septal cartilage. In patients with enophthalmos, the implants were stacked to reverse the malposition evident at surgery. RESULTS: Preoperatively, 27 patients had symptomatic diplopia. Postoperatively, the diplopia resolved in 15 patients and decreased in 7. No patients had induced diplopia or exacerbation of preoperative diplopia. Enophthalmos resolved in 9 of 18 patients. Hypoglobus was normalized in nine of nine patients. There was one major complication of orbital infection requiring explantation 1 week postoperatively. Minor complications included undercorrection, a symptomatically palpable implant, and transient postoperative chemosis. CONCLUSION: Porous polyethylene sheets offer several distinct advantages when used for orbital reconstruction. They are easy to handle, shape, contour, position, fixate, and use with other autogenous and alloplastic implants. In this series, these sheets permitted predictable, stable results with few complications.
Asunto(s)
Anoftalmos/cirugía , Enoftalmia/cirugía , Órbita/cirugía , Fracturas Orbitales/cirugía , Polietilenos , Prótesis e Implantes , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Materiales Biocompatibles , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Órbita/diagnóstico por imagen , Órbita/patología , Complicaciones Posoperatorias , Tomografía Computarizada por Rayos X , Resultado del TratamientoAsunto(s)
Lesiones Oculares Penetrantes/etiología , Lesiones Oculares/etiología , Enfermedades del Nervio Óptico/etiología , Traumatismos del Nervio Óptico , Heridas no Penetrantes/etiología , Lesiones Oculares/diagnóstico , Lesiones Oculares/terapia , Lesiones Oculares Penetrantes/diagnóstico , Lesiones Oculares Penetrantes/terapia , Humanos , Imagen por Resonancia Magnética , Enfermedades del Nervio Óptico/diagnóstico , Enfermedades del Nervio Óptico/terapia , Tomografía Computarizada por Rayos X , Campos Visuales , Heridas no Penetrantes/diagnóstico , Heridas no Penetrantes/terapiaRESUMEN
Two porous orbital implants available for clinical use in the anophthalmic socket are hydroxyapatite (HA) and porous polyethylene (PP). We examined the rate and the extent of fibrovascular ingrowth into these implants using histopathologic criteria in a rabbit model. Thirty-two New Zealand white rabbits underwent a unilateral enucleation with placement of a 14-mm spherical orbital implant. Twelve rabbits received HA, 12 small-pore PP, and 8 large-pore PP. The implants inserted were wrapped either in autologous sclera with and without anterior fenestrations or as unwrapped spheres. The implants were harvested at 6 and 12 weeks. The extent of fibrovascular ingrowth was assessed by determining the percentage of the cross-sectional area penetrated by fibrovascular tissue. On gross inspection, 12 implants (37.5%) were found to be exposed at harvesting; however, only two were grossly infected. The highest rate of exposure was found among the unwrapped implants. Wrapped versus unwrapped and fenestrated versus unfenestrated implants did not result in significant differences in the extent of vascularization. Hydroxyapatite implants were vascularized most rapidly. The small-pore PP implants did not become fully vascularized during the study, and yet complete vascularization was found in the large-pore PP at 12 weeks. The most intense areas of microscopic fibrovascular ingrowth were in the region where the extraocular muscles were in direct contact with the implant and at the posterior opening. Exposure of the implant was accompanied by chronic and acute inflammation. Both HA and large-pore PP spherical implants are capable of complete vascularization in this animal model.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Durapatita , Órbita/patología , Órbita/cirugía , Prótesis e Implantes , Animales , Enucleación del Ojo , Femenino , Neovascularización Patológica/patología , Órbita/irrigación sanguínea , Oseointegración , Polietilenos , Porosidad , ConejosRESUMEN
BACKGROUND: Magnetic resonance imaging (MRI) has excellent spatial and soft tissue resolution in the periocular and orbital region, especially when combined with surface coil techniques. Other methods, including computed tomography, dacryocystography, and dacryoscintigraphy provide limited information in the area of the lacrimal drainage system. Magnetic resonance imaging was used in conjunction with other imaging modalities to compare the anatomic detail and clinically relevant information obtained about various pathologic processes in the lacrimal drainage area. METHODS: Patients with a variety of lacrimal drainage disorders underwent MRI with either head or surface coils. Contrast agents also were used in selected cases. Seven case reports are presented. RESULTS: Magnetic resonance imaging provided detailed information about local anatomy, extent of pathology, and, in some cases, etiology of the pathology. CONCLUSIONS: Magnetic resonance imaging with surface coils provides detailed soft tissue information when compared with dacryocystography and computed tomography in the area of the lacrimal drainage system. In selected cases of lacrimal drainage system pathology, MRI may provide data that affect patient management.
Asunto(s)
Enfermedades del Aparato Lagrimal/diagnóstico , Aparato Lagrimal/patología , Imagen por Resonancia Magnética , Conducto Nasolagrimal/patología , Absceso/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Gadolinio DTPA , Humanos , Masculino , Mucocele/diagnóstico , Neoplasias/diagnóstico , Compuestos Organometálicos , Papiloma/diagnóstico , Ácido Pentético/análogos & derivados , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: The accepted surgical method for telecanthus repair is transnasal wiring. This procedure requires a stable posterior lacrimal crest on the affected side and surgical manipulation of the wires as they exit the contralateral side. A method for repairing telecanthus that obviates these prerequisites is presented. Indications for use of this technique and comparison to transnasal wiring is discussed. METHODS: A Y-shaped titanium rigid orbital plating system ("miniplate") was used to surgically correct traumatic telecanthus in five patients, two in the acute setting and three in late reconstruction. The miniplate was cantilevered from the lateral aspect of the nose and directed posteriorly into the orbit. This provided a stable fixation point for the medial canthal tendon. RESULTS: Marked resolution of the telecanthus was noted in four patients. No post-operative complications have been encountered to date. CONCLUSIONS: Miniplate fixation was used successfully to repair unilateral traumatic telecanthus. Miniplate fixation of the medial canthal tendon should be considered in unilateral cases of traumatic telecanthus and in cases where poor bony support for transnasal wires is evident.