By Thomas C. Spoor
This publication is a pragmatic, problem-orientated advisor to the administration of universal oculoplastic and orbital problems, and offers simplified options to complicated difficulties. this article covers higher and reduce eyelid surgical procedure and service in addition to orbital surgical procedure, and the prevention and remedy of strength problems. With great color surgical photos and illustrations, Atlas of Oculoplastic and Orbital surgical procedure is vital examining for ophthalmologists, oculoplastic surgeons, neuro-ophthalmologists and plastic surgeons.
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Additional info for Atlas of Oculoplastic and Orbital Surgery
12). Reason Graft not held in position long enough to let the fibrin glue secure it and graft too large to secure only with fibrin/thrombin sealant. 12 demonstrates a bulky lower eyelid secondary to a large ENDURAGen graft folding upon itself. The best treatment is prevention by securing a large graft with sutures, bolsters, and a Frost suture as necessary. Treatment Expose the graft through a subciliary incision. Then, thin the graft by excising the excessive material with scissors or shaving it with a #11 blade.
Ten to fifteen minutes after injection of xylocaine with hyaluronidase, the upper eyelid skin can be tented with forceps (A) and excised with scissors (B). 16 Severe bilateral orbital hemorrhage after rhinoplasty and lower eyelid blepharoplasty. Vision is decreased in the right eye due to a compressive optic neuropathy. 14 The skin graft is then sutured to the recipient site. The donor site may be closed with Indermil skin glue or sutures. 15 Pyogenic granulomas may occur at the lateral canthus (A) or lower eyelid incision site (B).
Treatments entail elevating the lower eyelid by either replacing the skin (anterior lamella) or implanting a spacer graft into the posterior lamella. Merely tightening the lower eyelid with 38 a tarsal strip type procedure without fixing the lamellar shortening usually worsens the condition by exacerbating the lower eyelid retraction [“belt and belly” phenomenon (Fig. 7)]. Less severe cicatrical ectropion (Fig. 12A) may be treated by lengthening the anterior lamella of the eyelid with a skin graft after releasing the cicatrizing forces with sharp dissection and shortening the eyelid with a tarsal strip procedure (Fig.