Medial upper eyelid shortening to correct medial eyelid laxity in floppy eyelid syndrome: A new surgical approach

Purpose: To describe and present the results of a new surgical technique for patients with floppy eyelid syndrome, based on the medial upper eyelid stretching encountered in this condition. Methods: A case series of 24 patients with floppy eyelid syndrome who where found to have symptomatic predominately medial upper eyelid laxity was analyzed. The history, clinical features, histopathology, and outcome were reviewed after patients underwent medial upper eyelid shortening with or without upper eyelid skin reduction as the first surgical procedure. Results: Of the 24 patients, 18 were men (75%) with a mean age at referral of 56 years, having ocular discomfort and conjunctival irritation/papillary conjunctivitis as the main complaints at presentation. Obesity was present in 96% of cases, with lower eyelid laxityl/ectropion (50%) and upper eyelid eyelash ptosis (29%) in conjunction with the upper eyelid laxity. The affected side was related to sleeping habits or recurrent mechanical eyelid trauma. Histologic studies showed a nonspecific inflammatory cell infiltrate and loss of elastin with loose dermal connective tissue. After surgery, complete relief of ocular symptoms and good functional and cosmetic results were present in all cases after 18 months of follow-up. Conclusions: This new surgical approach is based on the presence of predominately medial upper laxity in patients with floppy eyelid syndrome. The excision of this stretched area stabilized the upper eyelid in an anatomic fashion, providing a good and stable long-term result. The possible mechanisms involved in the medial upper eyelid stretching are discussed.

Anterior lamella actinic changes as a factor in involutional eyelid malposition

Purpose: We conducted a noncomparative, retrospective chart review of 45 patients and 51 eyelids with the diagnosis of involutional entropion or ectropion that underwent full-thickness lower eyelid shortening between June 2001 and February 2004, in whom the severity of actinic damage was analyzed in relation to the eyelid position. Patients with any different surgical approach or other primary causes of abnormal eyelid position, such as paralytic, congenital, or mechanical factors, were excluded. Methods: After excision, all eyelid specimens were examined by a single anatomic pathologist, who was masked to the type of eyelid malposition. The extent of dermal actinic change was evaluated under light microscopy, according to a previously validated grading system. Results: Fifty-one eyelids from 26 male and 19 female patients were analyzed. The mean age at the surgery was 76 +/- 10 years (range, 52 to 92 years), affecting one side in 39 cases and both sides in 6 cases. The most frequent eyelid malposition was ectropion, which affected two thirds of the cases (35 eyelids). Half of the patients presented with mild actinic skin changes; however, the severity of the histologic skin actinic changes was significantly worse in patients with ectropion in comparison to those with entropion (p < 0.0001). Conclusions: Actinic damage affecting the anterior lamella of the lower eyelid contributes as an additional factor in final eyelid position in patients with involutional eyelid changes. More severe and extensive actinic changes were present in eyelids with ectropion.

Lower level interior, C House, Coorparoo, Brisbane

View to landcape beyond from lower level interior.

Lower level floor plan, Brannigan House, St Lucia, Brisbane

Hand-drawn floor plan.

A method to lower the detection limit for optical beat signals from a frequency-dithered stabilized laser

A narrow absorption feature in an atomic or molecular gas (such as iodine or methane) is used as the frequency reference in many stabilized lasers. As part of the stabilization scheme an optical frequency dither is applied to the laser. In optical heterodyne experiments, this dither is transferred to the RF beat signal, reducing the spectral power density and hence the signal to noise ratio over that in the absence of dither. We removed the dither by mixing the raw beat signal with a dithered local oscillator signal. When the dither waveform is matched to that of the reference laser the output signal from the mixer is rendered dither free. Application of this method to a Winters iodine-stabilized helium-neon laser reduced the bandwidth of the beat signal from 6 MHz to 390 kHz, thereby lowering the detection threshold from 5 pW of laser power to 3 pW. In addition, a simple signal detection model is developed which predicts similar threshold reductions.

Lower studio dining room, Mooloomba House, Point Lookout, North Stradbroke Island

View through courtyard to lower studio dining room, as seen from upper living area.

Lower studio dining room, Mooloomba House, Point Lookout, North Stradbroke Island

View through courtyard to lower studio dining room, as seen from upper living area.

Lower studio dining room, Mooloomba House, Point Lookout, North Stradbroke Island

View through courtyard to lower studio dining room, as seen from upper living area.

Palynological reconnaissance of the Lower Carboniferous of Spitsbergen.

Microspores are described from three representative rock samples from the Billefjorden sandstones of the lower Carboniferous of central Vestspitsbergen. The age of this series is considered to range from Tournaisian to at least Visean and perhaps Namurian. One new genus, Velosporites, and thirteen new species are erected. Several species are shown to resemble previously described Russian, Canadian and Scottish types.

The Indotriradites dolianitii Morphon, a distinctive group of miospore species from the Lower Carboniferous of Gondwana

An emended diagnosis and generic reallocation are proposed for the trilete miospore Indotriradites dolianitii (Daemon, 1974) Loboziak et al., comb. nov. A new species, I. daemonii Loboziak et al., sp. nov., from Viséan strata of Western Gondwana, is erected. These two species, together with I. zosteriformis (Playford et Satterthwait) Playford, 1991 from the Viséan of Australia, belong to a cohesive morphological miospore category, here termed the Indotriradites dolianitii Morphon, which is evidently restricted to the Lower Carboniferous of Gondwana.

Radiizonates arcuatus, a distinctive new miospore species from the Lower Carboniferous of Western Gondwana

A new species of trilete zonate miospores, Radiizonates arcuatus, is established for Lower Carboniferous Western Gondwanan forms hitherto ascribed misguidedly to Radiizonates genuinus (Jushko) Loboziak and Alpern (1978), a Russian Lower Carboniferous species. The latter binomen is, moreover, not a valid combination and is more correctly designated as Vallatisporites genuinus (Jushko) Byvsheva, 1980. R. arcuatus is, from records to date, confined to westerly parts of Gondwana (Brazil, North Africa and Middle East), in which it is characteristic of Early Carboniferous strata, albeit with some slightly older and slightly younger occurrences.

Lower Carboniferous microfloras of Spitsbergen, Part One

Describes and discusses the stratigraphic value of dispersed microspores from Culm localities, particularly from three of the most complete sections of the Billefjorden sandstones in the region. Two successive microfloral assemblages are distinguished. Correlations can be made locally and with various zones of Europe and North America. One new genus and many new species are represented in the microfloras.

Sections of some spores from the Lower Carboniferous of Spitsbergen

Sections of four lower Carboniferous dispersed-spore species, Labiadensites fimbriatus (Waltz) Hacquebard and Barss, Cristatisporites echinatus Playford, Camptozonotriletes velatus (Waltz) Playford, and Spinozonotriletes uncatus Hacquebard, are discussed and illustrated.

Lower Carboniferous microfloras of Spitsbergen, Part Two.

Second part (and conclusion) of a paper on dispersed microspores from Culm (Carboniferous) localities, mainly in Billefjorden sandstones. Macroscopic lithologic data for samples are appended. "The present study lends considerable support to the view . . . that terrestrial sequences of lower Carboniferous age may be subdivided precisely on the exclusive basis of their microspore content.