Radiotherapy represents a major problem in facial surgery. Orbital and periorbital radiation therapy causes a contraction of the soft tissues. Scarring with ectropion is the most severe complication, with shrinking of the anterior lamella, skin dystrophy, muscle atrophy, and alteration of the remaining soft tissues. Goals for reconstruction include correction of distorted orbitofacial tissues a...

At the time of cataract extraction, the separation of lids and their maintenance in that position during the whole of the operative procedure have always been a headache for the ophthalmic surgeon. The traditional eye speculum, which has been used so far by nearly all the eye surgeons in this country, has the disadvantage that, in addition to retraction of the lids, its blades cause pressure on...

Ophthalmic Plastic and Reconstructive Surgery is a specialized area of ophthalmology that deals with the management of deformities and abnormalities of the eyelids, lacrimal system and the orbit. An ophthalmoplastic surgeon is able to identify and correct abnormalities of the ocular adnexae such as ectropion, lid retraction, conjunctival scarring with severe entropion, that can cause secondary ...

PURPOSE To evaluate the efficacy of transconjunctival Müller muscle recession and graded levator disinsertion for eyelid retraction in patients with thyroid-related orbitopathy (TRO). DESIGN Retrospective consecutive case series. METHODS Medical record review of 78 TRO patients (107 eyelids) who underwent surgery for upper eyelid retraction in a 5-year period was performed. Main outcome mea...

AIMS Thyroid associated orbitopathy (TAO) is an autoimmune disorder of extraocular muscles and orbital connective tissue. Identification of the principal target antigens would help the understanding of the pathogenesis of the disease and possibly lead to the development of specific therapies in the future. The purpose of this study was to measure serum antibodies against the flavoprotein subuni...

BACKGROUND Dry eye syndrome is a common sequela associated with periorbital surgery. As more patients seek periorbital rejuvenation, understanding the pathophysiology, diagnosis, and treatment of this condition perioperatively is essential for managing patient expectations and maximizing outcomes. METHODS A retrospective review of charts for 202 consecutive patients (180 women and 22 men) who...

Transcutaneous lower blepharoplasty addresses excess skin, muscle, and fat through an infraciliary cutaneous incision. This approach offers excellent exposure to the fat pads; however, violation of the orbital septum may result in postoperative lower eyelid retraction, with resultant aesthetic disfigurement as well as exposure keratoconjunctivitis.1 The transconjunctival approach to lower bleph...

IMPORTANCE Identifying a procedure to address lower eyelid retraction (LER) in the presence of an orbicularis deficit is a useful tool for aesthetic and reconstructive eyelid surgery. OBJECTIVE To describe and evaluate a surgical technique consisting of a closed canthal suspension and true lower eyelid retractor recession to address LER in the setting of orbicularis weakness. DESIGN, SETTING, A...