In this video, permanent punctal occlusion is performed with high-temperature thermal cautery for the treatment of refractory ocular surface dryness, in this case due to graft-versus-host disease.
Suzanne Freitag MD
Juan Carlos Jimenez Perez, MD
Benjamin Jastrzembski, MD
Harvard Medical School, Massachusetts Eye and Ear
One of the most common causes of lower lid ectropion is horizontal lid laxity, the incidence of which increases with age. This condition induces poor ocular surface tear film coverage which leads to irritation, tearing, and keratopathy. Lateral tarsal strip fixation is the technique which is widely used to repair involutional ectropion due to horizontal lid laxity. Medial spindle procedure is the well-known technique for puntal ectropion correction. Both surgeries are minimally invasive, simple and effective.
Suzanne K. Freitag, MD, Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School
Thidarat Tanking, MD, Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School
This combined procedure addresses multiple anatomic factors causing involutional entropion: the lateral tarsal strip is suspended to reduce horizontal laxity, and infraciliary rotation sutures are placed to stabilize the tarsus, evert the lower eyelid, and decrease orbicularis override. This approach is both efficient and effective, with a low risk of complications.
This video shows a combined upper lid internal recession and lower lid internal recession with placement of a tarsus posterior spacer graft in a patient with eyelid retraction due to thyroid eye disease.
Frontalis suspension blepharoptosis repair is the procedure of choice for the repair of blepharoptosis in the context of poor levator function (< 4mm). Numerous sling materials have been described for this procedure, however, preferred materials include banked, Tutoplast or autologous fascia lata, or silicone rods. This video demonstrates frontalis suspension utilizing silicone rods. Authors: Jay C. Wang, MD (Massachusetts Eye and Ear) Suzanne K. Freitag, MD (Massachusetts Eye and Ear)
The procedure in this video demonstrates a bi-lobed glabellar flap reconstruction after Mohs micrographic excision of a basal cell carcinoma in the medial canthus of the eyelids.
The procedure shown in this video is an upper lid retraction repair with platinum weight.
Dermis fat graft implantation has been used for decades to augment orbital volume and surface area in patients with congenital anophthalmia as well as those suffering complications of secondary anophthalmia following enucleation. It is most commonly performed as a means of socket reconstruction in patients with an exposed or extruded orbital implant and to prevent socket contracture. In this video, a dermis fat graft is harvested from the buttock and implanted into an anophthalmic socket for treatment of exposure of orbital implant in the right socket of a patient who was status post enucleation in both eyes for painful blind eyes.
Suzanne K. Freitag, MD
Victoria Starks, MD
Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School