Atlas of Oculoplastic and Orbital Surgery by Thomas C. Spoor

By Thomas C. Spoor

This e-book is a realistic, problem-orientated consultant to the administration of universal oculoplastic and orbital problems, and offers simplified strategies to advanced difficulties. this article covers top and decrease eyelid surgical procedure and service in addition to orbital surgical procedure, and the prevention and therapy of strength problems. With tremendous 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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10) for one to two days may be a helpful adjunct. If prevention is not possible—someone else’s complication—the graft may be thinned via a subciliary incision. The bulky, folded graft is exposed and the thickened portion is excised with scissors. This results in significant thinning of the eyelid with improved appearance (Fig. 13). Milder degrees of eyelid thickening (Fig. 14) can be dealt with in a similar fashion, thinning the graft with scissors after exposing it with a subciliary incision. 5 mm thick) ENDURAGen grafts.

This flattens the eyelid against the globe, smoothing both the graft and the lower eyelid. The final result should be a smooth eyelid with no retraction, maybe a little overcorrected since the patient is in the supine position (Fig. 2B). There should be no sutures touching the cornea either in primary or down gaze and no external bolsters. With experience, suturing may be eliminated with small to medium sized grafts. These may be fixated only with fibrin/ thrombin sealant (Evicel). Larger grafts may require fixation with a few sutures or 24 to 48 hours of upward traction utilizing a Frost suture.

Do not aggressively pull on the fat or reach into the orbit in an effort to remove excessive fat. The superior oblique tendon and trochlea lie deep in the fat pad, and although difficult to damage, when damage occurs it results in a very unhappy patient with diplopia that may be very difficult to treat. You should not see the tendon, the muscle, or the trochlea when removing the medial fat pad. If you do, you are too deep in the orbit for eyelid surgery. ). Treat the orbital fat and deeper orbital structures with respect, avoid and manage bleeding utilizing bipolar cauterization and moist cottonoids.

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