Eyelid, Tear Duct, and Orbital Surgery PowerPoint Presentation

Eyelid, Tear Duct, and Orbital Surgery PowerPoint Presentation

2015-09-28 78K 78 0 0

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Surgeries. Upper and lower eyelid. Blepharoplasty. – . Entropion. Repair. Ptosis. Repair – . Ectropion. Repair. Brow surgery. Brow . ptosis. repair. Tear duct. DCR (. re-routing . of the tear duct). ID: 143619

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Presentations text content in Eyelid, Tear Duct, and Orbital Surgery

Slide1

Eyelid, Tear Duct, and Orbital Surgery

Slide2

Surgeries

Upper and lower eyelid

Blepharoplasty

Entropion

Repair

Ptosis

Repair –

Ectropion

Repair

Brow surgery

Brow

ptosis

repair

Tear duct

DCR (

re-routing

of the tear duct)

Lacrimal

intubation

Orbital surgery

Fracture repairs

Tumor removal

Decompression resulting from Thyroid Disease

Slide3

Injections/Fillers

Botox

Juvederm

Radiesse

Cosmetic Eyelid Surgery

Slide4

Outpatient Surgery Centers

St. Francis Surgery Center

Methodist Germantown Surgery Center

Tri-State Surgery

Center

LeBonheur

East Surgery Center

Saint Francis Hospital

Methodist Germantown Hospital

Baptist East Hospital

Regional Hospital of Jackson

Slide5

Eyelid Surgery

Slide6

Upper Eyelid Blepharoplasty and Ptosis Repair Procedure

Skin to be removed is marked.

Incision is made along the skin markings on the upper eyelid.

Skin, muscle, and fatty tissue are removed.

For a ptosis repair, the muscle that raises the lid is also tightened.

Slide7

Blepharoplasty/Ptosis Repair

Before

After

Slide8

Ptosis Repair

Before

After

Slide9

Entropion and Ectropion Repairs

Entropion RepairIs a surgical procedure to fix an eyelid that is turning back towards the eyeEctropion RepairIs a surgical procedure to fix an eyelid that is turning outward.

Slide10

Entropion and Ectropion Repairs

For an ectropion repair, the lower tendon at the outer corner of the eye is exposed and tightened using an internal suture.

For an entropion repair, additional sutures are placed in the lower eyelid to help rotate the lid out, away from the eye.

Slide11

Entropion Repair

Before

After

After

Slide12

Ectropion Repair

Before

After

Slide13

Lower Eyelid Blepharoplasty

As we age, the fatty tissue under our eyelids tends to

protrude, and the lids sag.

In order to repair this, an incision is made either inside the lid to remove the fatty

tissue (

transconjunctival

blepharoplasty

) or

The incision can also be made below the lashes and extended to the outer corner. This is called a

transcutaneous

blepharoplasty

. With this approach, some excess skin can also be removed.

Slide14

Surgical Fixes for Excessive Tearing

There are many scenarios which can cause a person to experience excessive tearing

Eye irritation

Dry eyes (ironically)

Lower eyelid laxity

Blocked tear ducts

The first two can be treated with drops

The last two may require surgery

Slide15

The Tear Duct

The tear duct is like the drain in a sink, if it gets clogged, tears will run over the lid and down the

face (

epiphora

).

Slide16

17

The Tear Duct

There a few reasons a tear duct can fail to drain properly

The duct can narrow or close due to

Age (women, generally, have narrower tear ducts)

Chronic eye infections

Sinus/Allergy

problems

Chronic use of eye drops and some chemotherapy

Previous trauma or placement of

punctal

plugs

The duct may have a “stone” blocking the passage.

Slide17

Tear Duct Surgery

Minor tear duct surgery can be done in the office with local anesthesia.These procedures usually involve removing a foreign body or enlarging the opening.This may also involve irrigation of the lacrimal system.

17

Slide18

Tear Duct Surgery

Major tear duct surgery which typically involves re-routing the tear duct is done in the operating room under general anesthesia.

This procedure is called a DCR.

To begin, a small, half inch, incision is made between the eye and the nose.

A new, internal opening is made between the tear sac and the inside of the nose,

re-routing

the path through which tears drain.

Slide19

19

Tear Duct Surgery

Lastly, a small, flexible, silicone tube is placed, and acts as a stint to keep the new duct open.

This tube is generally kept in place for about 6 weeks and is removed easily through the nose, in the office.

Slide20

Post Op - Eyelids

For upper or lower lid surgery

Bruising generally lasts for 1 to 2 weeks

2 weeks if upper and lower eyelids are done simultaneously

Swelling can take a full month to go down, but a majority of it will decrease in the first week

For the first 24-48 hours, you should keep ice on the lids and sleep with your head elevated.

Slide21

21

Post Op - Eyelids

You will apply antibiotic ointment to the incisions twice a day, until your post-op appointment one week after surgery.

This type of surgery is typically not painful and pain medication is not usually needed after 1-2 days.

Slide22

Post Op – Tear Duct

Tear duct surgery

Is similar to the eyelid surgery course

Bruising and swelling is usually limited to one side

There is some additional risk of bleeding from the nose since part of the procedure requires work in the nose.

Slide23

Blood Thinners

You would need to be off of any blood thinners 5 to 7 days before surgery, unless otherwise discussed.

You may need to get a letter from the physician who monitors

this

stating that it is fine to be off

the blood thinner.

Slide24

24

Blood Thinners

Some

examples of blood thinners include

Over the Counter Prescription

Aspirin

Plavix

Vitamin E Coumadin (or

Warfarin

)

Ginko

Pradaxa

Ginseng

Aggrenox

Garlic supplement

Ticlid

Fish Oil

Efient

Slide25

Risks

Although eyelid and tear duct surgery is typically safe and uneventful, it is still surgery. Usual risks include:

Bleeding, which could affect your eyesight

Scarring

Infection

Asymmetry

Need for additional surgery

Anesthesia – Anesthesia staff will discuss with you before surgery

Slide26

Scheduling

If you did not schedule your procedure on your initial visit, we will get in touch with you over the next few days to set this up.

We are generally booked out about two weeks in advance.

Slide27

28

Scheduling

If you have a commercial insurance (CIGNA, BCBS, Aetna, United, etc), certain types of eyelid surgery may require pre-authorization. This can take up to 4-6 weeks.

Medicare does not require pre-authorization.

Slide28

James S. Linder, MD, PC

Thank you for giving us the opportunity to take care of you.

If you have any questions during this process, please call the office at (901) 680-1990, and speak to one of our staff members.


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