Epicanthus and/or telecanthus Choice of operation Correct large epicanthic folds with a Mustardé double Z -plasty ( 18.1 ). Smaller folds may be corrected with the simpler Y – V plasty ( 18.2 ). In congenital telecanthus the medial canthal…
Introduction An alternative to the separate reconstruction of each lamella of an eyelid is to use a flap which combines both lamellae. These flaps are taken only from the lower lid for reconstruction of the upper lid. Choice of operation…
Introduction In a full-thickness reconstruction of the upper or lower eyelid it is important to reconstruct the posterior lamella of the lid to give support to the reconstructed anterior lamella. In the upper lid it is essential that the posterior…
Introduction The eyelids have two lamellae – an anterior lamella of skin and orbicularis muscle and a posterior lamella of tarsal plate and conjunctiva. Partial-thickness defects of the lid or periocular region require reconstruction of only the anterior covering layer.…
Introduction In this chapter the direct closure of defects of the eyelid margin is described. Smaller defects may be closed directly without additional tissue. Larger lid margin defects may be closed directly with the addition of extra tissue from beyond…
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Introduction The emotional distress which frequently accompanies the removal of an eye is reduced considerably by a cosmetic final result. The appearance of the prosthesis will be enhanced and its mobility will be improved if a buried orbital implant is…
Introduction Corneal exposure is the most serious sequel to eyelid retraction. It may also occur with the eyelids in a normal position if there is poor closure, especially in the presence of reduced tear production, a poor Bell's phenomenon or…
Introduction A predictable sequence of changes occurs in the face as we age. Early changes are barely discernible and few seek a surgeon's help. Later, more obvious changes lead to a wide variety of cosmetic and functional surgical interventions. The…
Introduction More than any other oculoplastic surgery ptosis surgery depends on a thorough understanding of eyelid anatomy. Particular care must be taken in the assessment because not all ptosis should be corrected surgically. Classification Myogenic: Isolated congenital ptosis (congenital levator…