OBJECTIVE: Heavy brows in Chow Chow and Shar-Pei dogs can be associated with pseudoptosis and trichiasis-entropion of the upper eyelids, causing vision impairment and ocular discomfort. This study describes the outcomes of brow rhytidectomy ± Stades-like procedure to address these anatomical abnormalities.
METHODS: Retrospective medical records review (2019-2022).
RESULTS: Twenty-seven dogs (n = 15 Chow Chow, n = 12 Shar-Peis) were included, aged 1.9 ± 1.5 years (0.5-6.5 years). Presenting complaints included recurrent episodes of ocular inflammation (n = 13, 48.1%), blepharospasm (n = 10, 37.0%), corneal ulcers (n = 8, 29.6%), entropion (n = 6, 22.2%), and impaired vision (n = 4, 14.8%). Brow skin was removed as follows: (i) First incision parallel and 10-15 mm dorsal to upper lid, slightly extending beyond medial/lateral canthi; (ii) second incision forming an arc with its apex 15-35 mm dorsal to the first incision; and (iii) standard two or three layers closure. In 22/27 dogs, a Stades-like procedure was performed by removing a 2-4 mm strip of skin above eyelid margin and leaving it to heal by secondary intention (no sutures). At last recheck (follow-up 354.5 ± 187.8 days), 19/27 dogs (70.4%) had an adequate eyelid conformation, 7/27 dogs (25.9%) were considered under-corrected, and 1/27 dogs (3.7%) was over-corrected. Most owners (81.5%) were satisfied with the surgical results. Most cases (96.3%) had no recurrence of the clinical signs during the entire follow-up period.
CONCLUSIONS: Brow rhytidectomy ± Stades-like procedure provide good cosmetic and clinical outcomes in Chow Chow and Shar-Pei dogs, although under correction may occur in severely affected dogs and with advancing time.

A new therapeutic approach for enophthalmos may be retrobulbar lipofilling. This study aims to standardize the intraconal filling technique and to evaluate the degree of eyeball displacement by computed tomography (CT). Skull CT was performed on six dog cadavers before and after intraconal injection of two 5% iodinated, viscoelastic solutions, one per eye, using an ultrasound-guided supratemporal approach. The volume to be injected was calculated using formulas for retrobulbar cone anesthesia. After CT, the dogs underwent necropsy and histopathology to evaluate damages that eventually occurred to retrobulbar structures. Eyeball displacement was estimated using two CT-based methods, named M1 and M2. The Wilcoxon signed-rank test revealed no significant difference between the two injected materials in both M1 (p > 0.99), and M2 (lateral p = 0.84 and rostral p = 0.84 displacement). A statistically significant difference was found between the pre- and post-injection group M1 (p = 0.002), M2 (p = 0.004) for the lateral and (p = 0.003) for rostral displacement. Although the slight eyeball displacement, the retrobulbar filling can lead to enophthalmos resolution. Compared to M1, the M2 method has better-defined anatomical landmarks. Further, preclinical in vivo studies are necessary to assess retrobulbar filling efficacy and safety.

This study aimed to describe the epidemiology and clinical presentation of presumed hereditary or presumed breed-related ocular diseases in a population of cats in France.
Medical records from between September 2013 and August 2017 were reviewed to identify cats with at least one presumed hereditary or breed-related ocular disease. Cats with concurrent, or a history of, ocular or systemic infectious diseases were excluded. Signalment, history and clinical findings were recorded.
Of the 1161 cats that presented to our institution during the study period, 129 were diagnosed with at least one presumed hereditary or presumed breed-related ocular disease (11.1%, 95% confidence interval [CI] 9.3-12.9). Five ocular abnormalities had a prevalence of >1%: entropion, corneal sequestration, persistent pupillary membrane, cataract and retinal dysplasia. The prevalence of entropion was 2.2% (95% CI 1.3-3.0), with Persians (P = 0.03), Maine Coons (P <0.01) and male cats (P <0.01) being over-represented. The prevalence of corneal sequestration was 2.4% (95% CI 1.5-3.3), with Persians (P <0.01) and Exotic Shorthairs (P = 0.02) being over-represented. Persistent pupillary membranes and cataracts had the same prevalence of 2.3% (95% CI 1.5-3.2), with no particular sex or breed significantly over-represented. Retinal dysplasia had a prevalence of 1.6% (95% CI 0.8-2.3) and Persian cats were over-represented (P = 0.04). Anterior segment dysgenesis had a low prevalence (0.9%, 95% CI 0.4-1.5), with all affected cats being domestic shorthairs and this breed therefore was over-represented (P = 0.04).
In a French population of cats, presumed hereditary or breed-related ocular diseases accounted for 11.1% of all ocular diseases. Cataracts, corneal sequestration, persistent pupillary membrane, entropion and retinal dysplasia were the most common conditions. Statistical breed over-representation was observed for entropion, corneal sequestration and retinal dysplasia. We recommend that more systematic screening of feline species is conducted.

UNASSIGNED: Involutional entropion in the lower eyelid is one of the most common eyelid disorders of the elderly. Despite the effectiveness of the widely used surgical procedures, recurrence rates have failed to improve. In this retrospective study, we aimed to assess surgical plans, effectiveness and safety of tailored surgery based on the mechanical balance principal in treating involutional entropion in the lower eyelid.
UNASSIGNED: A retrospective analysis of 47 patients (54 eyelids) diagnosed with involutional entropion in the lower eyelid and receiving tailored surgical treatment based on mechanical balance principle from 1 January 2016 to 31 December 2018 was carried out. Tailored surgical plans were developed according to the mechanical balance analysis of vertical, horizontal and sagittal directions.
UNASSIGNED: All 54 eyelids with involutional entropion in the lower eyelid underwent advancement of the lower eyelid retractor (LER) through the conjunctiva. For patients with mild horizontal eyelid laxity, only LER advancement was performed. For moderate and severe horizontal eyelid laxities, combined horizontal reinforcement procedures were performed, including lateral canthopexy, lateral tarsal strip (LTS) surgery and wedge resection. The orbicularis oculi muscle (OOM) tightening or transposition was performed for OOM overriding. The follow-up time was 1 to 4 years, and there were no cases experiencing recurrence. Thus, the rates of effectiveness and recurrence were 100% and 0%, respectively.
UNASSIGNED: This is the first descriptive study on the tailored surgical strategies designed according to the mechanism of mechanical imbalance involved in involutional entropion. Tailored surgery based on the mechanical balance principle is safe and effective with low recurrence.

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OBJECTIVE: To describe the outcome of modified brow suspension technique for the treatment of upper eyelid pseudoptosis in canine patients with redundant frontal skin folds.
METHODS: Medical records from 1999 to 2015 were retrospectively reviewed. Only dogs that underwent modified brow suspension for treating bilateral pseudoptosis were included in the study. Recorded data included breed, age, gender, main ophthalmic complaint, ocular findings, suture material used for brow suspension, number of slings placed, postoperative treatment, complications, follow-up time, and outcome.
RESULTS: Twenty-five adult dogs of different gender and breed fulfilled the inclusion criteria, with the Shar-Pei being overrepresented (19/25;76%). The main complaint at first presentation was mucopurulent discharge (10/25;40%) and blepharospasm (10/25;40%). Concurrent corneal disease was diagnosed in 47 eyes (47/50;94%). Monofilament polyamide was the most frequently used suture material (46/50;92%). Number of slings placed varied, with one in two eyes (4%), two in 28 eyes (56%), three in 17 eyes (34%), and four in three eyes (6%). Complications were seen in three eyes (6%): suture rupture (one eye; 2%) and skin abscess (two eyes; 4%). Mean follow-up time was 17.6 months (1-84 months), with no cases of fold dermatitis or dermatologic disease observed within this period. Good esthetic and functional outcomes were obtained in 47 eyes at first intervention (97%) and in all patients after re-intervention.
CONCLUSIONS: The modified brow suspension technique described offers a surgical alternative for dogs with pseudoptosis secondary to redundant frontal skin folds that potentially reduces anesthetic time and facial changes.

Although the subcilliary or conventional transconjunctival approach has been widely used, it often fails to get acceptable visual fields or scars. This study directly compared the extended transconjunctival approach accompanied by lateral paracanthal incision with other traditional approaches in terms of surgical fields, the outcomes and complications. This retrospective chart review included 113 patients (82 males and 31 females; mean age: 38.7 years; range: 11-87 years), who underwent orbital reduction from November 2009 to September 2013. In extended transconjunctival approach, the external skin of the inferolateral canthal tendon was demarcated in a natural skin crease approximately 5 mm from the lateral canthus. The surgical approach was based on anteroseptal transconjunctival dissection. Paracanthal incision about 5 mm in length was performed. Esthetic and functional complications were evaluated, including the presence of a visible scar, lid retraction, or hypertrophic scar; epiphora, diplopia, global hematoma, persistent enophthamos, or exophthamos; and presence of entropion/ectropion. The extended transconjunctival approach resulted in a significant increase in the area of the surgical field statistically significant (P = 0.002). Complication rates are similar with other approach techniques. Postoperative scarring was confirmed by pictures taken in the outpatient clinic. The physicians\' average Vancouver scar scale (VSS) of first physician was 1.26 and second physician was 1.2. Compared with the conventional transconjunctival approach, the extended transconjunctival approach with paracanthal incision had similar complication and scarring rates, as well as a lower scarring rate than the subciliary approach while providing much wider surgical fields.

OBJECTIVE: The authors intended to evaluate the structural and cosmetic outcomes of medial epicanthoplasty.
METHODS: Medical records and photographs of 92 eyes from 46 Korean patients who underwent medial epicanthoplasty were reviewed retrospectively. The patients underwent epicanthoplasty using root Z-plasty, Y-V plasty, Mustarde\'s technique, and modified one-armed Mustarde\'s technique, from January 2009 to August 2011. Postoperative changes in the horizontal fissure width were measured for the assessment of structural outcome. The cosmetic outcomes were assessed in terms of appearance, symmetry, and scarring using a three-point grading system. Postoperative outcomes were evaluated at 1, 3, and 6 months after surgery.
RESULTS: Root Z-plasty, Y-V plasty, and Mustarde\'s method (including Mustarde\'s technique and modified one-armed Mustarde\'s technique combined) with medial canthopexy were performed on 64, 13, and 15 eyes, respectively. Six months after surgery, the horizontal fissure width increased by an average of 1.74 (8.4%), 1.64 (8.9%), and 1.89 mm (12.9%), respectively (p < 0.001, 0.041, and 0.027). In addition, root Z-plasty had a higher postoperative appearance grade than Y-V plasty and Mustarde\'s method (p < 0.001). Grades of symmetry were good for all methods, and grades of scarring were good for root Z-plasty and fair for the others. Scarring was significantly improved until postoperative 6 months in root Z-plasty and Y-V plasty (p < 0.001 and p = 0.022, respectively).
CONCLUSIONS: Medial epicanthoplasty increased the horizontal fissure width of about 1.7 mm. Most cosmetic outcomes were satisfactory, with root Z-plasty resulting in excellent outcomes. Scarring faded over time.

OBJECTIVE: To examine surgical outcomes of the posterior layer advancement of the lower eyelid retractors (LER) in patients with congenital entropion and to ascertain whether the pretarsal orbicularis oculi muscle (OOM) was hypertrophic or not.
METHODS: This retrospective study included three Japanese patients with congenital entropion who underwent posterior layer advancement of the LER. We reviewed the surgical outcomes and postoperative complications, such as lower eyelid ectropion and retraction for each patient. We also measured the diameters of the pretarsal OOM fibers in these patients and compared them with those measured in the previously reported 67 eyelids of 41 Japanese patients with congenital epiblepharon.
RESULTS: Congenital entropion was successfully corrected in all three patients without recurrence during 12-months of follow-up. No patient exhibited lower eyelid ectropion or lower eyelid retraction. The mean diameter of the pretarsal OOM fibers was 21.9 μm (range, 20.5-23.7 μm), which was not significantly different from that of the congenital epiblepharon (25.3 μm; range, 18.1-34.7 μm; p = 0.272, Mann-Whitney U test).
CONCLUSIONS: The surgical outcomes in the present study suggest that posterior layer advancement of the LER is a useful surgical option for treatment of congenital entropion. No histological evidence of pretarsal OOM hypertrophy was shown in congenital entropion, which demonstrated that debulking of the pretarsal OOM may not be significant for correction of this entity.