Ординатура / Офтальмология / Английские материалы / Atlas of Aesthetic Eyelid and Periocular Surgery_Spinelli, Lewis, Elahi_2004

I

Infection, wound, 164

Inferior lid retractor disinsertion, 34 Inferior oblique muscle, 6, 10, 11f Inferior orbital fissure, 9f

Inferior rectus muscle, 6, 10, 11f Inferior turbinate, 16f Infraorbital foramen, 9f

Intercommissure distance, shortening of, 35f Interposition graft

for lower lid retraction, 54, 55f

for upper lid retraction, 114, 116f, 117f Intraoperative complications, 161-165. See

also Operative complications. Involutional entropion, 29, 34, 35f

repair of, 52, 53f

Involutional ptosis, 29, 34, 35f, 94. See also Eyelid ptosis.

L

Lacrimal apparatus, 20, 21f

tear production in, 20-23. See also Tear(s). Lacrimal bone, 9f

Lacrimal drainage system, 12, 13f, 14, 15f, 16f

Lacrimal duct, 15f, 16f Lacrimal fossa, 9f Lacrimal gland, 8f, 9f, 16f

anatomy of, 20, 21f, 137 intraoperative injury of, 164 prolapse of, 20, 21f, 137, 138f

Lacrimal gland suspension, 137, 138f Lacrimal pump, 20, 22

Lacrimal puncta, 15f, 17f displacement of, 12, 13f

Lacrimal sac, 12, 13f, 14, 15f-17f Lagophthalmos

after ptosis correction, 94 preoperative evaluation of, 62 ptosis and, 94

Laser(s)

ablative, 154, 155-156 cooling devices for, 158, 159 nonablative, 154, 158-159 safety precautions for, 156

Laser resurfacing, 154-160 ablative, 154-157, 160

CO2 vs. erbium:YAG laser for, 155-156 intraoperative care in, 156-157 postoperative care in, 157 pretreatment in, 156

nonablative, 154-155, 157-160 candidate selection for, 158 dermal reaction in, 157-158 lasers for, 158-159 technique of, 158-159

Lashes, loss of, 164 Lateral canthal complex

transcutaneous approach to, 44, 45f upper eyelid approach to, 46, 47f, 48, 49f

Lateral canthal suspension procedures common canthoplasty, 46, 47f, 122,

123f

for cicatricial ectropion/entropion, 48-50, 48f-51f

Lateral canthal suspension procedures

(Continued)

for ectropion, 36-46, 37f, 39f-43f, 45f, 47f for exophthalmos, 150

for involutional entropion, 52, 53f for scleral show, 52-54, 54f, 55f indications for, 46

interposition grafts in, 54, 55f pearls and pitfalls for, 56

tarsal strip, 37f, 38, 39f-43f, 44, 45f transcutaneous approach in, 44, 45f upper eyelid approach in, 46, 47f

with midface suspension, 48-50, 49f-51f, 122-135

Lateral canthal tendon, 4f, 7, 7f-9f, 18, 19f laxity of, 34, 35f, 120

tightening of. See also Lateral canthal suspension procedures.

lacrimal puncta displacement and, 12, 13f

Lateral canthus

as midface component, 120 inclination of, 23, 34, 35f

Lateral fat pad, 11f. See also Orbital fat. Lateral rectus muscle, 10, 11f

Lateral retinaculum, 4f, 18, 19f Lateral tarsal strip procedure

results of, 37f

technique of, 38, 39f-43f

Le Fort III procedure, for exophthalmos, 150, 152f, 153f

Levator advancement, 102-109 eyelid retraction after, 112 indications for, 98

results of, 107f-109f

technique of, 102-103, 104f-107f, 109f Levator aponeurosis, 3f-5f, 6, 7

dehiscence of, ptosis and, 92, 94

lateral horn of, insertion of, 7, 8f, 18, 19f supertarsal fixation of, 68, 70f

Levator palpebrae superioris muscle, 6-7, 7f, 10, 11f

functional evaluation of, 95, 96f, 97f Levator recession, for upper lid retraction,

114, 115f-117f Levator tuck

for ptosis

indications for, 98 technique of, 102

in upper lid blepharoplasty, 68, 70f Lid aperture, measurement of, 95, 97f Lid lag

after ptosis correction, 94 preoperative evaluation of, 62 ptosis and, 94

Limbal goblet cells, 20, 21f Lockwood‘s ligament, 4f, 7f, 18 Lower canaliculi, 15f-17f Lower eyelid

as midface component, 120 displacement of, 23, 25f

extrinsic distraction forces on, 23, 24f, 25f gross examination of, 28-29

homeostasis of, 23, 24f, 25f intrinsic support for, 23, 24f, 25f

normal position of, 6, 23, 24f, 25f, 28 relationship of to upper eyelid, 5f, 6

Lower eyelid (Continued) rhytidectomy in, 80, 81f snap back test for, 29, 36

transconjunctival approach to, 84-85, 86f transcutaneous approach to, 45f, 73-74, 75f

Lower eyelid blepharoplasty, 72-89 complications of, 161-165. See also

Operative complications. midface position and, 72 preoperative evaluation for, 72 transconjunctival, 80-89

advantages and disadvantages of, 73 indications for, 73, 80, 82f, 83f pearls and pitfalls for, 85

results of, 82f, 83f technique of, 84-85, 86f-89f

vs. transcutaneous approach, 72-73 transcutaneous, 72-78

advantages and disadvantages of, 72 cutaneous vs. myocutaneous flaps in,

72-73 indications for, 73

pearls and pitfalls for, 78 preoperative planning in, 72, 78 technique of, 73-74, 75f-77f, 79f

vs. transconjunctival approach, 72-73 with midface suspension, 132, 133f, 134f

Lower eyelid laxity. See also Eyelid malposition.

modified lateral tarsal strip procedure for, 38, 39f-43f

pinch test for, 36

snap back test for, 29, 36

tarsal tuck for, 44, 45f, 90-91, 91f Lower eyelid ptosis. See Eyelid malposition. Lower eyelid retraction, 33f, 34, 52-54, 54f,

55f. See also Eyelid malposition. evaluation of, 29, 33f

in Graves‘ disease, 146, 150, 151f-153f in zygomatic fractures, 146-147 pathophysiology of, 34

repair of, 52-54, 54f, 55f

Lower eyelid shortening, full-thickness, for lid laxity, 36

Lower eyelid–upper eyelid relationship, 5f, 6

M

Malar eminence, position of, evaluation of, 29, 31f, 33f

Malar support evaluation of, 29, 31f inadequate, 33f

Marcus-Gunn jaw-winking phenomenon, 95 Maxilla bone, 9f

Medial canthal tendon, 12, 13f insertions of, 9f

Medial canthus

anatomy of, 12-14, 13f, 15f-17f, 18, 19f inclination of, 35f

Medial fat pad, 10, 11f. See also Orbital fat. Medial rectus muscle, 10, 11f

Meibomian glands, 2, 20 Mid face

age-related changes in, 120, 121f anatomy and physiology of, 120, 121f components of, 120

Superior rectus muscle, 10, 11f Superior sulcus deformity, 94 Supertarsal fixation, 68, 70f

Supraorbital neurovascular bundle, location of, 137

Supratrochlear neurovascular bundle, location of, 137

Surgical anatomy, 2-26. See also specific structures.

pearls and pitfalls for, 26

Surgical complications, 161-165. See also Operative complications.

Surgical procedure, selection of, 32

T

Tarsal conjunctival müllerectomy eyelid retraction after, 112

indications for, 98 technique of, 99, 100f, 101f

Tarsal goblet cells, 20, 21f Tarsal plate, 2, 3f, 6, 8f

in lower eyelid support, 23

lateral canthal tendon and, 18, 19f

Tarsal tuck with fat repositioning, 44, 45f, 9091, 91f

Tarsorrhaphy, temporary

in enophthalmos repair, 147-148 in exophthalmos repair, 150

Tear film, 16f, 20 evaluation of, 30, 31f inadeqaute

after ptosis repair, 95 in ptosis, 98-99

refractive properties of, 20, 22 Tear trough deformity, iatrogenic, 165 Tear(s). See also under Lacrimal.

aqueous phase of, 20, 22 blinking cycle and, 16f, 22 constituents of, 20 distribution of, 22

drainage of, 12, 13f, 14, 15f, 16f, 22 evaporation of, 22

ptosis repair and, 98-99 homeostasis of, 22-23 layers of, 20

production of, 14, 16f, 20, 21f Schirmer test for, 29, 31f, 95

quality of, evaluation of, 29-30 Tetrafluoroethane spray, for nonablative

lasers, 158-159 Thyroid ophthalmopathy

exophthalmos in, 146, 150, 151f-153f

Thyroid ophthalmopathy (Continued)

upper lid retraction in, 112. See also Upper eyelid retraction.

Transconjunctival lower lid blepharoplasty, 80-89

indications for, 80, 82f, 83f pearls and pitfalls for, 85, 86f-89f results of, 82f, 83f

technique of, 84-85, 86f-89f Transcutaneous lower lid blepharoplasty, 72-

78

advantages and disadvantages of, 72 cutaneous vs. myocutaneous flaps in, 72-73 indications for, 73

pearls and pitfalls for, 78 preoperative planning in, 72, 78 technique of, 73-74, 75f-77f, 79f

U

Upper canaliculi, 15f-17f Upper eyelid

age-related differences in, 58, 59f, 61f baggy, 58, 59f, 61f

deep-set, 58, 59f

gross examination of, 28-29 maximal arch of, 28

normal position of, 6, 28, 94 normal variations in, 58, 59f racial differences in, 58, 59f, 61f

relationship of to lower eyelid, 5f, 6 superior sulcus deformity of, 94

Upper eyelid approach, to lateral canthal tendon and midface, 46, 47f, 48, 49f

Upper eyelid blepharoplasty, 58-70 brow fat pad debulking in, 137-138,

139f

browplasty/browpexy in, 137-138, 139f141f

complications of, 161-165 eyebrow position in, 60, 62, 63f eyebrow ptosis and, 63f, 68, 70f in Asians, 68

lacrimal gland suspension in, 137, 138f lid crease position in, 62, 63f, 68, 70f pearls and pitfalls for, 68

preoperative evaluation for, 58-62 preoperative planning in, 62, 63f, 66f technique of, 62-68, 64f-67f, 69f, 70f

Upper eyelid excursion, measurement of, 95, 96f, 97f

Upper eyelid fold, position of

in blepharoplasty, 62, 63f, 68, 70f

Upper eyelid fold, position of (Continued) normal, 94

racial differences in, 58, 59f, 61f supertarsal fixation and, 62, 63f, 68, 70f

Upper eyelid ptosis, 92-111. See also Eyelid ptosis.

Upper eyelid retraction, 112-118 after ptosis surgery, 112 contralateral, 113f

in Graves‘ disease, 112, 146, 150, 151f-153f interposition graft for, 114, 115f-117f postoperative, 163-164

weight insertion for, 114, 118f

Upper eyelid–lower eyelid relationship, 5f, 6

V

Visual acuity testing, 29, 31f

Visual loss, due to retrobulbar hemorrhage, 161-162

W

Weight insertion, for upper lid retraction, 114, 118f

Whitnall‘s ligament, 3f, 4f, 7, 7f-9f, 19f, 21f Whitnall‘s tubercle, 4f, 7, 9f, 18, 19f Wound care, after laser resurfacing, 157 Wound dehiscence, 162-163

Wound infection, 164 Wrinkles

laser resurfacing for, 154-160. See also Laser resurfacing.

lower lid rhytidectomy for, 80, 81f

X

Xerophthalmia

after ptosis repair, 95 eyelid ptosis and, 98-99 postoperative, 164

Z

Zygomatic bone, 9f

Zygomatic fracture, enophthalmos and, 146147, 148f, 149f, 150

Zygomatic osteotomy

for enophthalmos, 146-148, 148f, 149f for exophthalmos, 150, 151f-153f

Zygomaticofacial foramen, 9f Zygomaticofrontal suture, 9f