Journal Club - Predictability and Risk Factors in Orbital Surgery for Cavernous Venous Malformations

About The Guest:
- Dr. Kyle J. Godfrey is an assistant professor in the Departments of Ophthalmology and Neurological Surgery and the Ophthalmology Residency Program Director at Wild Cornell Medicine and New York Presbyterian Hospital in New York, New York.
- Dr. Evan Kalin-Hajdu is an assistant professor at the University of Montreal and a member of the department of Ophthalmology at Maisonneuve-Rosemont and Ste. Justine hospitals in Montreal, Quebec.
- Dr. Amina Malik is the director of Ophthalmic Plastic and Reconstructive Surgery and an associate professor at the Blanton Eye Institute at Houston Methodist Hospital. She also has a joint appointment in the Department of Otolaryngology at Houston Methodist and an academic affiliation at Texas A&M and Wild Cornell Medicine.
- Dr. Gary Lelli is the vice Chair of Ophthalmology, Director of Ophthalmic Plastic and Reconstructive Surgery, and an associate professor at Wild Cornell Medicine and New York Presbyterian Hospital in New York, New York.
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Summary:
Dr. Kyle Godfrey hosts a discussion with Dr. Evan Kalin-Hajdu, Dr. Amina Malik, and Dr. Gary Lelli about three selected articles from the current issue of OPRS Journal. The first article discusses the predictability of the phenylephrine test in congenital ptosis, the second article evaluates the incidence and risk factors for poor postoperative visual outcomes after excision of orbital cavernous venous malformations, and the third article presents a surgical technique for reconstructing large full-thickness lower eyelid defects. The experts provide their insights and opinions on the articles, discussing the findings, limitations, and potential implications for clinical practice.
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Key Takeaways:
- MMCR is a viable option for moderate levator function congenital ptosis, and the phenylephrine response appears to be the most valuable predictor of surgical outcome.
- Surgical excision of orbital cavernous venous malformations carries a risk of vision loss, and the incidence and risk factors for poor postoperative visual outcomes should be carefully considered.
- The reconstruction of large full-thickness lower eyelid defects can be achieved using remnant eyelid rotation, semicircular skin and muscle flaps, and lateral tarsoconjunctival flaps, providing good cosmetic outcomes and avoiding the need for a second stage reconstruction.

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