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Entropion correction

Entropion is an inward turning or rolling of the eyelid which is rarely seen in babies and more common in the elderly due to aging and weakening of the eyelid muscles. There are various surgical techniques for treating entropion. In general, the eyelids are tightened to bring them back to normal position and restore function. The surgery is carried out under local anesthesia as an outpatient procedure. You might be recommended to use an antibiotic ointment for a week after surgery and you can expect to recover within a week. The Quickert procedure/non-incisional repair is another procedure for treating entropion. It is performed on patients who prefer a non-surgical treatment or cannot undergo surgery. This procedure involves the eversion of the eyelid under local anesthesia by placing sutures at various strategic points. This is an excellent procedure with quick results.

Ectropion correction

Ectropion is an age-related condition characterized by outward folding of the eyelids (most commonly the lower lid). The procedure involves tightening of the tendons of the lower eyelid usually at the outer corner. It is performed on a day case basis under local anesthesia. The skin is closed by dissolvable sutures. You will be advised to clean the eyelids and apply an antibiotic ointment for 2 weeks to avoid infection.

Lid reconstruction

There are several conditions that cause defects in the eyelids, such as trauma and removal of tumor growths. Most of the time, the localized wound heals within a week or 10 days. Sometimes, a few sutures will be necessary for closing the wound and can be done as an outpatient procedure. In some of the complex cases, the doctors may recommend the transfer of adjacent tissue (flaps) or skin grafting to reconstruct the eyelids. The complete procedure requires more than one operation and is called staged reconstruction.

Coloboma correction

The coloboma is a congenital (present at birth) defect in the eyelid. The common location of coloboma is the junction of the medial and middle third of the upper lid. The appearance varies from having a small cleft to almost the absence of the eyelid. In this condition, a part of the cornea is exposed, which causes dryness in the eye. If the damage is minimal, the treatment generally recommended is extra lubrication to prevent excessive dryness caused by the evaporation of tears. If the cornea is moderately damaged, then soft contact lenses and moisture chambers will be recommended. Surgery might be considered eventually as an option to treat coloboma if the lubrication and contact lenses are not found to be successful and the corneal damage is severe.

Symblepharon release +AMG/MMG

Symblepharon is a condition characterized by partial or complete adhesion of the eyelid and eyeball. This can be caused as a complication of several eye infections and diseases like conjunctivitis, dry eye syndrome, chemical injury, etc. It can be prevented by splitting up the raw surfaces for two weeks using a soft contact lens, before the process of wound healing. This technique can avoid the need for mucous membrane grafts and amniotic membrane grafts. If symblepharon has already formed, then an oculoplastic procedure (i.e., mucous membrane grafts and amniotic membrane grafts) is necessary to release them. The superficial dissection will be performed initially to separate the eyelid and eyeball and release the symblepharon sticking between them. The mucus membrane from the buccal mucosa or conjunctiva or amniotic membrane will be harvested. The extra fat will be removed from the graft and the mucous membrane will be placed on the raw surface area of the eyelid and stitched securely. A bandage contact lens will then be placed over the eyeball. You may be advised to apply an antibiotic ointment for the first 5 days to avoid infection. A general eye lubricant may be recommended for 6 months after grafting.

Trichiasis/Distichiasis correction

Distichiasis is a rare congenital disorder characterized by abnormal growth of eyelashes behind the meibomian gland, a type of sebaceous gland at the eyelid rim. Trichiasis is defined as a condition where the abnormally grown eyelashes rub the cornea (eyeball) and cause irritation and abrasions Use of eye lubricants and bandage contact lenses may provide temporary relief. Mechanical epilation (removal of abnormally grown eyelashes by forceps) is considered a reliable method of treatment. However, the eyelashes regrow and electrocautery or cryotherapy becomes necessary. These procedures are generally carried out under local anesthesia. Electrocautery involves the electrical burning of specific areas of eyelash growth through a special needle. Cryotherapy is a freezing method of treatment that destroys the abnormal tissue and thus prevents abnormal growth of eyelashes. The most effective and permanent method of treatment is eyelash trephination. This surgical technique involves boring of abnormal eyelash follicles followed by complete removal of the follicle.

Gold weight implantation

Gold weight implantation is generally performed to treat people who have a facial paralysis. During facial paralysis, the person loses the normal protective mechanism of eye closure and blinking. Initially, this condition is treated with eye lubricants and later on, gold weight implantation is recommended to restore the function of eyelids. This is a quick surgical procedure performed under local anesthesia. A small cut is made along the eyelid and a weight (gold strip) is placed in the pocket. The weight is then sutured securely in a proper position. This is commonly done for upper eyelids to provide support. This facilitates the normal closing of the eye while blinking and sleeping.

Incision and curettage

Incision and curettage is a surgical method of treatment for a chalazion. A chalazion is a condition of swelling in the eyelid. It is usually non-infective and painless and can occur in both upper and lower eyelids. Incision and curettage are performed under local anesthesia. A clamp is placed to hold the eyelid backward. A small cut is made with a surgical blade from the underside of the eyelid. The inflammatory debris is removed from the cyst and the cavity is cleaned thoroughly. An antibiotic ointment will be applied and the eye is padded for 24 hours. You will be advised to apply antibiotic ointment at least 3-4 times a day for one week.

Medial/Lateral canthoplasty

Canthoplasty is cosmetic surgery of elongating the eyes. This is generally performed on oriental people who have a Mongolian fold. Lateral canthoplasty is the procedure where elongation is done laterally or outward (towards the ear). Medial canthoplasty is done to establish distinct and large eyes. The surgery is performed on both the eyelids. Local anesthesia is administered and incision and suture technique is adapted to elongate the eyes. An appropriate medicine will be advised to treat swelling which will subside gradually in 8-12 weeks.

Tarsorraphy

Tarsorraphy is a procedure for the treatment of various ocular surface disorders and ocular exposures. The procedure involves stitching the upper eyelid and lower eyelid precisely at the corners to bring the eyelids closer to facilitate lubrication and wound healing in several eye disorders. Tarsorraphy is performed as an outpatient procedure under local anesthesia in people with facial paralysis and weakness of eyelids.

Lid tumor excision + repair

Eyelid tumor excision is a common surgery performed under local anesthesia. The tumor in the eyelid can either be benign or malignant or present as a small lump around the eyelids. The surgeon removes the tumor and the wound is repaired carefully under high magnification. Reconstruction of the eyelid is then performed with direct closure, flaps (transfer of nearby tissue), or grafts.

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