Ophthalmology

Atlas of Oculofacial Reconstruction: Principles and by Gerald J. Harris MD FACS

By Gerald J. Harris MD FACS

This full-color atlas is a pragmatic, step by step advisor to the reconstruction of periocular defects following tumor excision or tissue-loss trauma. The e-book addresses the categorical anatomic matters in every one oculofacial quarter with adapted surgical rules and strategies designed to enhance aesthetic outcomes.

Full-color illustrations with exact explanatory legends depict every one step of every surgical strategy. Flap layout and mobilization are proven at once on surgical pictures, instead of in idealized drawings. The transparent, obtainable writing variety will attract ophthalmic and plastic surgeons, non-ophthalmic surgeons, and non-surgical ophthalmic specialists.

A significant other web site will comprise an internet snapshot bank.

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Additional info for Atlas of Oculofacial Reconstruction: Principles and Techniques for the Repair of Periocular Defects

Sample text

Medial eyelid crease and lateral crow's-foot incisions were used to develop a skin flap, which was anchored laterally at the orbital rim with a buried 5-0 polyglactin 910 suture and fixed to the new tarsal margin with running 7-0 nylon suture (see Fig. 58). 57. 59 A. A marginal defect extending to but not involving the right upper punctum. B. Reconstruction with a tarsoconjunctival flap transposed to the margin and resurfaced with a skin flap (see Fig. 60). 59. 61 A. 59. B. The patient 6 months after surgery, showing the conjunctival aspect of the reconstructed right upper eyelid (see Fig.

C. The tarsal defect was â squared offâ (white dotted line) and a free tarsal graft (yellow dotted line) was harvested from the superior aspect of the same tarsus. The graft was secured with 6-0 polydioxanone monofilament suture with anterior knots, and was surfaced with a skin flap (black dotted lines) sutured at the eyelid margin with running 7-0 nylon (see Fig. 54). 53. 5-mm defect of tarsus and levator aponeurosis, with a larger anterior lamellar deficit. A similar-size graft from the upper tarsal border was sutured to residual tarsus medially with two 6-0 chromic catgut sutures, to the remnant of canthal tendon laterally with two 6-0 polyglactin 910 sutures, and to residual tarsus and levator aponeurosis superiorly with running 6-0 plain catgut suture.

Options include a tarsoconjunctival flap resurfaced with a skin graft or flap, and a tarsal free graft resurfaced with a flap. 34 The classic Wendell Hughes3 procedure combines a tarsoconjunctival transposition flap from the upper eyelid with a full-thickness skin graft. The upper eyelid is everted, and the height of the required tarsus is measured downward from the upper tarsal border (white solid line), maintaining at least 4 mm of marginal 33 34 tarsus. The flap width is 2 mm less than the defect width, as measured with moderate tension on the defect edges.

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