Telemedicine for Preoperative Evaluation of Upper Eyelid Malposition

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Lilly H. Wagner ◽  
Aaron M. Fairbanks ◽  
David O. Hodge ◽  
Elizabeth A. Bradley
Keyword(s):  
Preoperative Evaluation ◽  
Upper Eyelid ◽  
Eyelid Malposition

scholarly journals One Time New Surgical Correction for Severe Upper Eyelid Acquired Ptosis

2017 ◽  
Vol 54 (3) ◽  
pp. 502-504
Author(s):  
Gheorghe Noditi ◽  
Mihail Cojocaru ◽  
Dan Grigorescu ◽  
George Noditi
Keyword(s):  
Surgical Approach ◽  
Preoperative Evaluation ◽  
Operative Procedure ◽  
Surgical Correction ◽  
Self Control ◽  
Palpebral Fissure ◽  
Active Muscle ◽  
Upper Eyelid ◽  
Frontalis Muscle ◽  
Chronic Use

Palpebral ptosis is a condition caused by different congenital and acquired pathologies. Seeing difficulty due to the visual field obstruction, prefrontal headaches due to chronic use of the frontalis muscle in an attempt to lift the eyelids and cosmetic deformity are the main complaints of the patients. The surgical correction of the ptosis can be challenging. According to the preoperative evaluation, the most appropriate technique should be used to maximize the postoperator result. We describe a new surgical approach for severe upper eyelids acquired ptosis consisting in reanimation of both eyelids by using the neighboring active muscle. We considered the patient a good candidate for the new surgical approach we introduce as one time operative procedure. The result was a normal palpebral fissure for both eyes. The advantage of this approach consists in performing one time surgery followed by immediate postoperative mobilization of the upper eyelids which determine the recovery of the upper lids motility by further self-control.

Upper Eyelid Blepharoplasty

2011 ◽  
Author(s):  
Jed Poll ◽  
Michael T. Yen
Keyword(s):  
Ocular Surface ◽  
Preoperative Evaluation ◽  
Anterior Segment ◽  
Skin Incision ◽  
Upper Eyelid ◽  
Orbital Fat ◽  
History Of ◽  
Superior Sulcus ◽  
And Function ◽  
Orbital Rim

The purpose of this chapter on blepharoplasty is to familiarize the reader with relevant eyelid anatomy, appropriate preoperative evaluation, and the surgical fundamentals of upper eyelid blepharoplasty. In addition, modern modifications of blepharoplasty will be presented, with special attention to aesthetic blepharoplasty and surgical considerations in the Asian eyelid. Blepharoplasty defines a group of surgical procedures by which excess skin, orbicularis muscle, and orbital fat are removed from the upper eyelids. The ideal goal of blepharoplasty is to rejuvenate the eyelid and restore a youthful eyelid position without compromising eyelid function. A postoperative taut upper eyelid resulting in lagophthalmos and ocular surface compromise equates to an unsatisfied patient and surgeon. Likewise, excessive orbital fat excision can create a sunken superior sulcus and an eyelid contour with an undesirable cosmetic appearance. Similar to many other oculoplastic procedures, many variations in surgical technique in blepharoplasty have been employed over the years. Despite the differences, all these modifications rely upon the same underlying fundamental principles. Key steps in successful blepharoplasty surgery occur before the first skin incision is made. The eyelids are not islands unto themselves; rather, they are intimately connected to other facial structures, most notably the brow and forehead for upper lid blepharoplasty and the midface complex for lower lid blepharoplasty. Failure to preoperatively address pertinent nearby structures can yield unwanted postsurgical results. In addition to the assessment of facial structure, a preoperative blepharoplasty evaluation should include a proper medical and ocular history. Patients with a bleeding diathesis or a history of anticoagulation should be counseled and anticoagulation medications withheld if medically appropriate. A history of ocular surface issues or previous anterior segment surgery should be investigated and a slit-lamp examination performed to assess for dryness and corneal pathology. Conditions that can affect eyelid position, such as myasthenia gravis and thyroid-related orbitopathy, should be stable for a minimum of 6 months prior to blepharoplasty. Assessing brow position and function is essential when considering a patient for upper eyelid blepharoplasty. Normal brow position in males is along the superior orbital rim, and in females normal brow position is about 1 cm superior to the orbital rim.

An Update on Subciliary Lower Eyelid Blepharoplasty

2021 ◽  
Author(s):  
Ozcan Cakmak ◽  
Ismet Emrah Emre
Keyword(s):  
Postoperative Care ◽  
Surgical Planning ◽  
Preoperative Evaluation ◽  
Lower Eyelid ◽  
Orbicularis Oculi Muscle ◽  
Orbicularis Oculi ◽  
The Past ◽  
Tear Trough Deformity ◽  
Eyelid Malposition ◽  
Orbital Rim

AbstractThe subciliary lower eyelid blepharoplasty has evolved considerably to create a more harmonious natural appearance with a fuller and unoperated look and also to minimize the complications. While lower eyelid malposition was very common in the past, now this complication is significantly reduced by attention to preoperative evaluation, meticulous surgical planning, precise surgical technique, and postoperative care. Various prophylactic maneuvers maintaining/strengthening lower lid support can be utilized to prevent lower lid malposition including preservation of the pretarsal orbicularis oculi muscle, conservative resection of skin and muscle, and suspension of the orbicularis oculi muscle and/or tarsus to the periosteum of the lateral orbital rim. The release of the orbicularis retaining ligament and surgical transposition of orbital fat over the rim rather than excision allows for smoothing of the lid-cheek junction, filling the tear trough deformity, and reducing the appearance of bulging fat in the lower eyelid. In this article the reader will find a comprehensive approach for achieving a smooth contour with gradual blending at the lower eyelid–cheek junction while maintaining/restoring normal lower lid support. A descriptive outline of postoperative care is also provided to help in optimal healing for the patient.

Management of Cosmetic Eyelid Surgery Complications

2003 ◽  
Vol 20 (2) ◽  
pp. 83-88 ◽  
Author(s):  
William P. Mack ◽  
Mont J. Cartwright ◽  
John P. Fezza ◽  
Patrick M. Flaharty
Keyword(s):  
Dry Eye ◽  
Preoperative Evaluation ◽  
Lower Eyelid ◽  
Dry Eye Syndrome ◽  
Surgery Complications ◽  
Medication History ◽  
Upper Eyelid ◽  
Eyelid Surgery ◽  
Intraoperative Management ◽  
Orbital Hemorrhage

Purpose: Preoperative evaluation with detailed surgical planning is imperative to avoid potential complications in cosmetic eyelid surgery. Materials and Methods: Before undergoing cosmetic upper eyelid blepharoplasty, patients should be thoroughly evaluated. Patients should be examined for ptosis, dry eye syndrome, prolapsed lacrimal gland, and brow ptosis. In addition to the evaluation for dry eye syndrome, patients interested in cosmetic lower eyelid blepharoplasty should be assessed for ectropion, entropion, lid retraction, scleral show, lid laxity, and lagophthalmos. Preoperatively, risk factors for orbital hemorrhage, including hypertension, anti-platelet or anticoagulant medication, history of abnormal bruising of bleeding, or underlying diseases that may contribute to bleeding, should be assessed. Intraoperative management of cosmetic upper eyelid surgery complications should focus on decreasing the risk of postoperative ptosis, lagophthalmos, lid retraction, and lid asymmetry, with special attention to limiting the risk of visual loss secondary to orbital hemorrhage. Discussion: Management of cosmetic lower eyelid blepharoplasty complications should focus on methods to assess lower lid laxity, limit the risk of diplopia, and manage orbital hemorrhage. Results: Techniques to revise cosmetic eyelid surgery complications during the postoperative period will be described.

Blepharoptosis Treatment Options during Upper Eyelid Cosmetic Blepharoplasty

2003 ◽  
Vol 20 (2) ◽  
pp. 73-82
Author(s):  
John G. Rose ◽  
Bradley N. Lemke ◽  
Steven C. Dresner ◽  
Mark J. Lucarelli
Keyword(s):  
Visual Field ◽  
Effective Treatment ◽  
Preoperative Evaluation ◽  
Treatment Options ◽  
Surgical Techniques ◽  
Field Testing ◽  
Visual Field Testing ◽  
Upper Eyelid ◽  
Orbital Septum

Introduction: To describe surgical techniques of blepharoptosis treatment during upper eyelid cosmetic blepharoplasty. Materials and Methods: All patients underwent a preoperative evaluation, including eyelid position measurements, visual field testing, and, where appropriate, phenylephrine testing. Standard upper eyelid blepharoplasty skin/orbicularis excision was performed, exposing the orbital septum. External levator repair was then performed through an 8-mm incision in the orbital septum. In other patients, internal ptosis repair was performed transconjunctivally following upper eyelid blepharoplasty. Results: Ptosis repair methodologies of internal versus external approaches are compared and contrasted. Discussion: Combining ptosis repair with cosmetic blepharoplasty is a safe, effective treatment for patients who demonstrate both dermatochalasis and ptosis.

scholarly journals Eyelid Malposition Repair: A Review of the Literature and Current Techniques

2019 ◽  
Vol 33 (02) ◽  
pp. 092-102 ◽  
Author(s):  
Ashley Guthrie ◽  
Pooja Kadakia ◽  
Joshua Rosenberg
Keyword(s):  
Preoperative Evaluation ◽  
Current Evidence ◽  
Review Of The Literature ◽  
Comprehensive Understanding ◽  
Complex Anatomy ◽  
Wide Range ◽  
Facial Plastic ◽  
Eyelid Malposition ◽  
Reconstructive Techniques ◽  
Methods Of Reconstruction

AbstractEyelid malposition is a challenging problem faced by surgeons. Given the delicate nature of the eyelid and its complex anatomy, eyelid repair requires both a comprehensive understanding of eyelid anatomy along with thorough presurgical planning and surgical execution. A wide range of options is available for eyelid reconstruction but the location and extent of the deformity often dictate the type of repair. This article is a review of commonly encountered forms of eyelid malposition. Relevant reconstructive techniques and current evidence-based methods of reconstruction are discussed in detail. Anatomical considerations, the nature of specific defects, pearls of preoperative evaluation, and the reconstructive options available to the facial plastic and oculoplastic surgeon are outlined. Topics discussed include ectropion, entropion, eyelid retraction, and blepharoptosis.

Outcomes of enucleation and porous polyethylene orbital implant insertion in patients with paediatric retinoblastoma: a long-term follow-up study

2020 ◽  
pp. bjophthalmol-2020-317934
Author(s):  
Min Kyu Yang ◽  
Min Joung Lee ◽  
Namju Kim ◽  
Hokyung Choung ◽  
Sang In Khwarg
Keyword(s):  
Upper Eyelid ◽  
Free Survival ◽  
Implant Exposure ◽  
Group A ◽  
Eyelid Malposition ◽  
Group B ◽  
Upper Eyelid Ptosis ◽  
Group D

Background/AimsTo report the long-term outcomes of enucleation and insertion of porous polyethylene (PP) orbital implant according to the evolving surgical techniques and implant in patients with paediatric retinoblastoma .MethodsPatients with paediatric retinoblastoma who underwent enucleation and PP implant insertion from December 1998 to December 2014 were retrospectively reviewed and divided into four groups: group A, classic enucleation +PP implant; group B, enucleation +PP implant +anterior closure of the posterior Tenon’s (ACPT) capsule; group C, enucleation +PP implant +free orbital fat graft +ACPT and group D, enucleation +smooth surface tunnel PP implant +ACPT. Survival analysis of implant exposure and eyelid malpositions was performed.ResultsOne hundred and ninety-eight eyes of 196 patients were included. The median follow-up period was 13.0 years (range, 5.0–21.1). A 20 mm implant was inserted for 149 eyes (75.3%). The 10-year exposure-free survival probabilities were 44.6% in group A, 96.4% in group B, 97.4% in group C and 97.7% in group D. ACPT was associated with significant reduction in implant exposure (p<0.001). The most common eyelid malposition was upper eyelid ptosis (24.2%). The eyelid malposition-free survival probability did not differ among the four groups. However, the insertion of a 20 mm implant was associated with significant reduction in upper eyelid ptosis and lower eyelid entropion (p=0.004 and 0.038, respectively).ConclusionsThe long-term postenucleation implant exposure was rare after PP implant insertion and ACPT, even with a 20 mm-diameter implant. A larger implant can be beneficial in long-term prevention of eyelid malposition.

Surgical Management of Patients With 22q11.2 Deletion Syndrome

2019 ◽  
Vol 4 (5) ◽  
pp. 857-869
Author(s):  
Oksana A. Jackson ◽  
Alison E. Kaye
Keyword(s):  
Surgical Management ◽  
Preoperative Evaluation ◽  
Preoperative Assessment ◽  
22Q11.2 Deletion Syndrome ◽  
Deletion Syndrome ◽  
22Q11.2 Deletion ◽  
Surgical Decision ◽  
Obstructive Sleep ◽  
Spine Abnormalities ◽  
Speech Assessment

Purpose The purpose of this tutorial was to describe the surgical management of palate-related abnormalities associated with 22q11.2 deletion syndrome. Craniofacial differences in 22q11.2 deletion syndrome may include overt or occult clefting of the palate and/or lip along with oropharyngeal variances that may lead to velopharyngeal dysfunction. This chapter will describe these circumstances, including incidence, diagnosis, and indications for surgical intervention. Speech assessment and imaging of the velopharyngeal system will be discussed as it relates to preoperative evaluation and surgical decision making. Important for patients with 22q11.2 deletion syndrome is appropriate preoperative screening to assess for internal carotid artery positioning, cervical spine abnormalities, and obstructive sleep apnea. Timing of surgery as well as different techniques, common complications, and outcomes will also be discussed. Conclusion Management of velopharyngeal dysfunction in patients with 22q11.2 deletion syndrome is challenging and requires thoughtful preoperative assessment and planning as well as a careful surgical technique.

Minimally Invasive Repair of Pectus Excavatum (MIRPE) - The Basel Experience

Swiss Surgery ◽  
2003 ◽  
Vol 9 (6) ◽  
pp. 289-295 ◽  
Author(s):  
Haecker ◽  
Bielek ◽  
von Schweinitz
Keyword(s):  
Minimally Invasive ◽  
Pectus Excavatum ◽  
Pulmonary Function Tests ◽  
Preoperative Evaluation ◽  
Skin Incision ◽  
Original Method ◽  
Restrictive Lung Disease ◽  
Cardiac Compression ◽  
Cardiac Evaluation ◽  
Indications For Operation

Purpose: Minimally invasive repair of pectus excavatum (MIRPE) was first reported in 1998 by D. Nuss. This technique has gained wide acceptance during the last 4-5 years. In the meantime, some modifications of the technique have been introduced by different authors. Our retrospective study reports our own experience over the last 36 months and modifications introduced due to a number of complications. Methods: From 3/2000 to 3/2003, 22 patients underwent MIRPE. Patients median age was 15.5 years (10.7 to 20.3 years). Standardised preoperative evaluation included 3D computerised tomography (CT) scan, pulmonary function tests, cardiac evaluation with electrocardiogram and echocardiography, and photo documentation. Indications for operation included at least two of the following: Haller CT index > 3.2, restrictive lung disease, cardiac compression, progression of the deformity and severe psychological alterations. Results: In 22 patients (2 girls, 20 boys) undergoing MIRPE procedure, a single bar was used in 21 patients and two bars in one boy. Lateral stabilisers were fixed with non resorbable sutures on both sides. Overall, postoperative complications occurred in six patients (27.3%). In two patients (9.1%) a redo-procedure was necessary due to bar displacement. An additional median skin incision was performed in two patients to elevate the sternum. Pneumothorax or hematothorax in two patients resulted in routine use of a chest tube on both sides. Long-term favourable results were noted in all patients. Conclusions: The MIRPE procedure is an effective method with elegant cosmetic results. Modifications of the original method help to decrease the complication rate and to accelerate acquirement of expertise.

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