Atlas of Oculoplastic and Orbital Surgery by Thomas C. Spoor

By Thomas C. Spoor

This publication is a realistic, problem-orientated consultant to the administration of universal oculoplastic and orbital problems, and offers simplified strategies to complicated difficulties. this article covers top and decrease eyelid surgical procedure and service in addition to orbital surgical procedure, and the prevention and remedy of capability problems. With magnificent color surgical images 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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Example text

As the 48 assistant applies gentle pressure to the globe, incise the medial fat pad capsule with the hot Ocutemp™ cautery. The white orbital fat will egress from the capsule and may be clamped, cauterized, inspected, and released (Fig. 9) without causing excessive bleeding. Only clamp, cauterize, and remove the medial fat pad that egresses from the capsule. 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.

The eyelid height and contour is observed and the suture is adjusted accordingly (Fig. 23A–C). The central suture controls the height of the eyelid. You may alter the contour of the eyelid by placing a suture nasal or temporal to the central suture. In most patients, this is not necessary if the central suture is placed about 14 mm from the upper punctum (Fig. 23D) or at the nasal end of a dehisced tarsus. If it does not look right at the time of surgery, it is not going to improve with time. What you see is what you get.

23A–C). The central suture controls the height of the eyelid. You may alter the contour of the eyelid by placing a suture nasal or temporal to the central suture. In most patients, this is not necessary if the central suture is placed about 14 mm from the upper punctum (Fig. 23D) or at the nasal end of a dehisced tarsus. If it does not look right at the time of surgery, it is not going to improve with time. What you see is what you get. Adjust the eyelid height and contour until you are pleased with the appearance, then tie the suture with three or four knots.

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