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Purpose: 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. Materials and 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. [ABSTRACT FROM AUTHOR]

Purpose: To show the morphological characteristics of two different types of the sinus of Maier, one with a lacrimal sac diverticulum supplied by separate canalicular openings, and the other with a terminal dilatation of the common lacrimal canaliculus. Methods:Twelve coronal specimens (6 right and 6 left) from 6 Japanese cadavers (age range, 70–90 years at death) and 15 axial specimens of 11 Japanese cadavers (8 right, 7 left; age range, 45–89 years at death), fixed in 10% buffered formalin, were used. All specimens were stained with Masson’s trichrome. Results: The sinus of Maier, with a lacrimal sac diverticulum supplied by separate canalicular openings, was shown in one coronally sectioned group, with a diameter of 1.29 mm. The mucosa between both openings (0.282 mm length) comprised stratified squamous epithelia, which was characteristic of the lacrimal canaliculi. The diverticular mucosa was lined by a stratified columnar epithelium, which corresponded to the lacrimal sac. The sinus of Maier, with a terminal dilatation of the common lacrimal canaliculus and with a diameter of 0.51 mm, was demonstrated in one axially sectioned group. Conclusions: The morphological characteristics of two types of the sinus of Maier were described in this study. One type was the lacrimal sac diverticulum supplied by separate canalicular openings, and the other was the terminal dilatation of the common lacrimal canaliculus. [ABSTRACT FROM PUBLISHER]

Purpose: The aim of this study was to examine the length and diameter of the intra-sac portion of the lacrimal canaliculus and to propose a modified functional valve model at the common internal ostium. Methods: We examined 14 eyelid and orbital specimens from 10 cadavers (seven right, seven left; aged 45-85 years at death), fixed in 10% buffered formalin. Sliced specimens were dehydrated and embedded in paraffin, cut into 7 μm thickness sections, and stained with Masson's trichrome. We then measured the length and diameter of the intra-sac portion of the lacrimal canaliculus. Results: The average length of the intra-sac portion of the lacrimal canaliculus was 1344.9 μm (range, 920.2-1821.5 μm), and its average diameter was 287.5 μm (range, 199.1-523.3 μm). Conclusion: The intra-sac portion of the lacrimal canaliculus had an average length and diameter of 1344.9 μm and 287.5 μm, respectively. The lacrimal sac mucosa changes its thickness with autonomic stimulation, and the length and diameter of the intra-sac portion of the lacrimal canaliculus is likely changed concurrently. The long length and small diameter of the intra-sac lacrimal canaliculus presumably contribute to it acting as an autonomic functional valve at the common internal ostium. [ABSTRACT FROM AUTHOR]

The anatomy of the lateral canthus is analogous to that of the medial canthus, but with a less defined structure. Although the lateral canthal tendon occupies the major part of the lateral canthal anatomy, the lateral rectus capsulopalpebral fascia and other structures also play a significant role. Appropriate comprehension and consideration of the lateral canthal anatomy enable safe and effective performance in the lateral canthal surgeries. In this review, we present the lateral canthal anatomy along with updated topics. We discuss the lateral canthal tendon, lateral orbital thickening, lateral palpebral raphe, lateral canthal muscle, lateral rectus capsulopalpebral fascia, lateral check ligament, lateral retinaculum, and orbitomalar ligament. [ABSTRACT FROM AUTHOR]

A right orbit was exenterated from a male cadaver that was 85 years of age at death. It was microscopically shown for the first time that the lacrimal sac septum divided the lumen into two spaces. It consisted of fibrous tissue with a cavernous structure and was lined with stratified columnar epithelium similar to the lacrimal sac wall. [ABSTRACT FROM AUTHOR]