Eyelid Reconstruction

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• Relaxed lid margin furnishes poor support and allow lid eversion postoperatively • Wedge excision of tarsus and lid margin, the graft can be placed directly over the closure with good graft ―take‖ Lower Eyelid Reconstruction FULL THICKNESS DEFECTS • Frozen section • Reconstruction can be delayed 20
Direct Closure 30% defects in young patients Up to 45% in older patients (laxity) Lateral cantholysis - additional 5 mm Tarsal defect should be squared • The excision is vertically oriented in the tarsus: pentagon shape • Approximation of the pentagon: straight lid margin without notching • The knot must be tied away from the conjunctiva to prevent irritation • The wound is closed in three layers 21
Page 1 and 2: Eyelid Reconstruction Introduction
Page 3 and 4: Anatomy Tarsus - Dense, fibrous ti
Page 5 and 6: Anatomy Orbital Septum - Fascial b
Page 7 and 8: • Lower - marginal artery • Up
Page 9 and 10: • V - median palpebral arterial v
Page 11 and 12: Anatomy Anatomy 11
Page 13 and 14: Anatomy Lateral canthal tendon - l
Page 15 and 16: Anatomy Lacrimal Excretory Pump Lac
Page 17 and 18: Eyelid Reconstruction • Skin graf
Page 19: Lower Eyelid Reconstruction PARTIAL
Page 23 and 24: The “extensile” approach: A:
Page 25 and 26: C: If lateral cantholysis is not ad
Page 27 and 28: Mustarde Rotational Cheek Flap Goo
Page 29 and 30: • Over correction in the vertical
Page 31 and 32: Free Tarsal Graft Tripier bipedicle
Page 33 and 34: Hughes Procedure (continued) ―Use
Page 35 and 36: ― Medial canthal reconstruction u
Page 37 and 38: • An excellent flap for local cov
Page 39 and 40: Sliding Tarsoconjunctival Flap Iso
Page 41 and 42: Posterior Lamellar Graft with Local
Page 43 and 44: Pedicle Flap From Lower Lid Full-th
Page 45 and 46: Lateral Canthal Reconstruction Late
Page 47 and 48: Medial Canthal Reconstruction Relat
Page 49 and 50: CORRECTION OF PTOSIS • When deali
Page 51 and 52: • Neurogenic ptosis includes CN I
Page 53 and 54: • Previous problems:excessive tea
Page 55 and 56: B: Fascia is inserted between the o
Page 57 and 58: Mild/Moderate ptosis with fair to g
Page 59 and 60: Mustarde’s “split-level” tars
Page 61 and 62: • The usual amount of plication i
Page 63 and 64: ― Aesthetic eyelid ptosis correct
Page 65 and 66: • Loss of eyelashes: may occur, p
Page 67 and 68: Entropion Correction of congenital
Page 69 and 70: Entropion Correction of involution
Page 71 and 72:
Entropion Correction of cicatricia
Page 73 and 74:
Ectropion Congenital - Insufficien
Page 75 and 76:
Ectropion Correction of paralytic
Page 77 and 78:
Ectropion Correction of cicatricia
Page 79 and 80:
Ectropion Correction of involution
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Eyelid Reconstruction

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