Download Atlas of Oculoplastic and Orbital Surgery by Thomas C. Spoor PDF

By Thomas C. Spoor

ISBN-10: 1841845868

ISBN-13: 9781841845869

This publication is a realistic, problem-orientated advisor to the administration of universal oculoplastic and orbital problems, and gives simplified suggestions to complicated difficulties. this article covers top and reduce eyelid surgical procedure and service in addition to orbital surgical procedure, and the prevention and therapy of strength problems. With significant 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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Example text

Clamp the fat with a hemostat, excise the clamped fat with a scissor (Fig. 18B), and cauterize the clamped fat with bipolar cauterization. Release the hemostat while holding onto the fat with a pair of forceps (Fig. 18C). Examine the fat for residual bleeding—if present, cauterize the offending vessel(s) (Fig. 18D). If not, release the stump of fat into the orbit. If bleeding later seems to occur, do not deny it, but gently press on the globe to expose the fat and cauterize the bleeding vessel with bipolar cautery.

Develop a skin-muscle flap in the following fashion. Make a button hole incision through the orbicularis muscle at the lateral end of the incision. Place a hemostat into the incision and extend it along the horizontal length of the eyelid beneath the orbicularis muscle. Spreading the hemostat develops the skin-muscle flap, which can then be totally mobilized by incising the incision line with scissors (Fig. 5). Hemostasis is obtained with wet field or hot cauterization. Hemostasis may be augmented by placing pledgets soaked in a solution of xylocaine with epinephrine fortified with topical 10% phenylephirine eye drops onto the wound (one drop of phenylephirine per cubic centimeter of local anesthetic has been safe in our experience).

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. The entire graft may be removed and replaced. If the graft material is scarred into position, it is easier to thin it with scissors, then make an incision beneath it along its entire horizontal length. This recesses and elevates the lower eyelid.

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