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Pre-Op Evaluation

How to Avoid and or Treat Periocular and Eyelid Surgical Complications 36 th Annual Hugh Greenway Superficial Anatomy & Cutaneous Surgery www.superhealthyliving.com Steven Pratt MD, FACS, ABIHM La Jolla, California. 2. Pre-Op Evaluation. Fat Pockets Medial Webbing Patient Expectations

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Pre-Op Evaluation

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  1. How to Avoid and or Treat Periocular and Eyelid Surgical Complications36th Annual Hugh Greenway Superficial Anatomy & Cutaneous Surgerywww.superhealthyliving.comSteven Pratt MD, FACS, ABIHMLa Jolla, California

  2. 2

  3. Pre-Op Evaluation • Fat Pockets • Medial Webbing • Patient Expectations • Doctor’s Expectation • Lid Crease Position • Slit Lamp Exam?

  4. Pre-Op Evaluation • Lagophthalmos • Previous Surgery • Pre-Existing Lash Loss • Pre-Existing Scars • Brow Position • Medications • Platlet Inhibitors – herbals. ***** • Fair Complexion and Red Hair

  5. Pre-Op Evaluation • Asymmetry = Take Photo • Psychological Profile • h/o Dry Eye/Keratitus • h/o Claustrophobia • Schirmer Test? • Bell’s Phenomenon • Corneal Sensation • Thyroid Evaluation – Lid Retraction • h/o Laser Vision Therapy • Lid Margin Disease • h/o laser skin resurfacing

  6. RED FLAG

  7. Treatment options

  8. Sleeping Mask Post Suture Removal ?

  9. SOMETIMES A FULL THICKNESS LID BIOPSY IS NECESSARY

  10. Periocular Surgery

  11. Excise and Granulate

  12. Excise and Suture

  13. Avoid Skin Graft Here

  14. Pedicle Advancement Flap

  15. Cautery Ablation of Hypertrophic Skin Grafts

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