Oculoplastic Surgery Technique Videos

by Richard C. Allen, MD, PhD, FACS

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Eyelid biopsy

• Basic eyelid biopsy (00:46)
• Biopsy of upper lid margin lesion (01:14)
• Full-thickness wedge biopsy (02:04)
• Posterior wedge resection (02:11)
• Excision of upper and lower xanthelasma #1  (02:37) 
• Excision of upper and lower xanthelasma #2 (02:33)
• Excision of sub-brow lesion (01:59)

Examination Videos

Basic exam

• Distance visual acuity (00:47)
• Near visual acuity (00:28)
• Confrontation Visual Field Testing (00:27)
• Ocular motility exam (00:37)
• Cover test (00:50)
• Pupil exam (01:06)
• Slit lamp exam (3:17)
• Intraocular pressure measurement with Tonopen (00:47)
• Direct ophthalmoscopy (00:46)

Oculoplastics exam

• External examination (01:12)
• Hertel measurement (00:36)
• Lacrimal system examination (01:29)
• Forced duction testing (00:25 )
• Forced traction test (00:53 )

Accessory testing

• Amsler grid (00:30)
• Color vision testing (00:37)
• Red top test (00:22)
• Stereo visual acuity (00:31)
• Fluorescein staining of the cornea (00:26)
• Schirmer test (00:28)
• Eversion of the upper eyelid (00:28)
• Applying drops (00:17)
• Placement of a pressure patch (01:00)

Chalazion

• Incision and drainage of external chalazion (01:24)
• Incision and drainage of chalazion upper eyelid (01:34)
• Incision and drainage of chalazion lower eyelid (01:44)

Conjunctival biopsy

• Conjunctival biopsy (01:16)
• Conjunctival map biopsies (01:22)
• Conjunctivoplasty for conjunctivochalasis (01:35)
• Mucous membrane graft for severe atopic (05:06)
• Biopsy of subconjunctival lymphoma (01:31)
• Excision of lipodermoid (dermolipoma) (03:07)
• Resection of prolapsed orbital fat into the subconjunctival space (02:02)

Brow ptosis

• Direct browplasty (03:22)
• Direct browplasty (02:36)
• Paralytic brow ptosis repair (02:40)
• "Gull-wing" browplasty (02:02)
• Internal suture browpexy (04:05)
• Transblepharoplasty endotine browpexy (2:59)
• Browplasty using prominent forehead wrinkles (03:35)
• Mid-forehead browplasty (03:28)
• Pretrichial browplasty (05:11)
• Temporal scalp incision browplasty (05:56)
• Cutting the conjoint tendon (temporal fusion line) (03:00)
• Small incision browplasty (07:30)
• Small incision browplasty in a male patient (05:22)
• Small incision browplasty with transaction of corrugators (04:17)
• Double fixation of repair of brow ptosis  (02:48)
• Small incision browplasty with headlight mounted camera  (05:45)  
• Scalp incision details for a small incision browplasty (04:08)
• Small incision browplasty with elevation of the medial brow (02:59)

Blepharoplasty

• Upper
• Bilateral upper eyelid blepharoplasty (03:26)
• Upper eyelid blepharoplasty with monopolar cautery (03:22)
• Upper blepharoplasty (02:59)
• Skin only upper blepharoplasty (03:32)
• Asian upper blepharoplasty (04:21)
• Raising the upper lid crease (03:57)
• Maximal eyelid surgery with a single external blepharoplasty incision (06:35)
• Lower
• Transconjunctival lower lid blepharoplasty with fat reposition (03:00)
• Transconjunctival lower lid blepharoplasty with fat resection (03:08)
• Transcutaneous lower lid blepharoplasty with fat resection (04:12)
• Lower eyelid blepharoplasty with direct festoon excision (04:47)

Ptosis

• Congenital
  • Pediatric levator advancement (04:25)
  • Levator advancement for congenital ptosis (04:05)
  • Demonstration of the orbital septum in a pediatric patient (01:36)
  • Fascia frontalis sling (03:13)
  • Revision of autologous fascia frontalis sling (05:01)
  • Pediatric bilateral frontalis sling (02:59)
  • Silicone frontalis sling for congenital ptosis (03:46)
  • Bilateral silicone frontalis suspension for congenital ptosis (03:36)
  • Levator extirpation with silicone frontalis sling (04:03)
  • Muller muscle-conjunctival resection in a pediatric patient (02:44)
• Adult
  • External levator advancement (04:12)
• Levator advancement #2 (04:58)
• Levator advancement in a patient with a deep superior sulcus (03:42)
• Bilateral silicone frontalis suspension (05:22)
• Intraoperative details of silicone frontalis suspension (02:20 )
• Revision of silicone frontalis sling (02:22)
• Fasanella servat procedure (03:11)
• Müller muscle conjunctival resection #1 (01:57)
• Müller muscle conjunctival resection #2 (02:07)
• MMCR with externalization of suture knots (02:21)
• MMCR with burying of suture knots under conjunctiva (02:55)

Upper entropion

• Upper eyelid tarsotomy (02:41)
• Anterior lamellar recession (upper lid) (02:15)
• Mucous membrane graft for repair of upper lid cicatricial entropion (03:36)

Upper lid retraction

• Modified full-thickness blepharotomy (02:21)
• Full-thickness blepharotomy with debulking of medial and brow fat pads (05:01)

Lower lid ectropion

• Involutional
  • Medial spindle with lateral tarsal strip for repair of ectropion (03:10)
  • Inverting sutures with upper canthoplasty and lateral tarsal strip (03:13)
  • Transconjunctival retractor reinsertion with lateral tarsal strip for the treatment of involutional ectropion (02:57)
• Cicatricial
  • Full thickness skin graft for cicatricial ectropion (02:25)
  • Full-thickness skin graft to lower eyelid for thermal burn (04:02)
  • Steroid injection to decrease contracture in a skin graft (01:28)
  • Maximal repair of involutional lower lid ectropion (05:21)

Lower lid entropion

• Involutional/spastic
  • Transcutaneous retractor reinsertion with lateral tarsal strip for the treatment of involutional entropion (02:17)
  • Everting or Quickert sutures (01:13)
• Cicatricial/other
  • Anterior lamellar recession (lower lid) (01:50)
  • Lower eyelid tarsotomy (02:07)
  • Repair of lower lid cicatricial entropion with an anterior lamellar recession and retractor reinsertion (03:49)
  • Repair of cicatricial entropion with Quickert sutures, tarsal fracture, and lateral tarsal strip (04:22)
  • Mucous membrane graft with fornix sutures for shallow fornix in an anophthalmic socket  (04:48) 
  • Cryotherapy for eyelash follicle destruction (02:21)
  • Epiblepharon repair (02:36)
  • Repair of congenital lower lid entropion (03:29)   

Lower lid retraction

• Hard palate graft for lower eyelid retraction (02:15)
• Enduragen graft to lower eyelid (04:17)
• Placement of Enduragen graft with inverting sutures (05:11)
• Placement of Enduragen graft with pillar tarsorrhaphy (04:52)
• Lower lid elevation with ear cartilage graft (06:53)
• Repair of lower lid retraction with a hard palate graft and medial pillar tarsorrhaphy (02:45 )
• Retractor recession with medial and lateral tarsorrhaphy (03:43)

Mid-face lifts

• Drill hole midface lift (05:54)
• Preperiosteal cheek lift with Vicryl suture (03:40)
• Mid-face lift with Endotine midface B device (05:30)

• Small incision browplasty with midface elevation (04:63)

Canthoplasties

• Lateral tarsal strip (02:23)
• Lateral tarsal strip with upper canthoplasty (03:14)
• Transblepharoplasty canthopexy (01:51)
• Floppy eyelid syndrome repair (04:21)
• Periosteal strip for lateral canthal disinsertion (03:32)
• Periosteal strip to increase the width of the palpebral fissure (02:36) 
• Multiple z-plasties for medial canthal web (03:17)
• Repair of medial canthal web with skin graft (01:57)

Tarsorrhaphy  

• Permanent
• Medial tarsorrhaphy (01:40)
• Lateral tarsorrhaphy (02:40)
• Pillar tarsorrhaphy (02:32)
• Revision of pillar tarsorrhaphy (01:25)
• Revision of type II Boston keratoprosthesis (01:53)
• Temporary
• Glue tarsorrhaphy (00:44)
• Temporary bolster tarsorrhaphy (01:38)
• Temporary suture tarsorrhaphy (01:21)
• Severing of lateral tarsorrhaphy (00:41)
• Severing of tarsorrhaphy and steroid injection (02:19)

Gold weight

• Gold weight insertion (02:08)
• Removal of gold weight (01:13)
• Repositioning of gold weight (03:23)
• Placement of "high" upper eyelid weight (03:08)

Telecanthus

• Repair of epicanthus inversus and telecanthus in blepharophimosis (03:37)

Ear

• Repair of torn earlobe (02:15)

Lid reconstructions

• Lower lid
  • Central
    • Full thickness wedge resection repair (02:04)
    • Posterior wedge resection #2 (03:01)
    • Repair lower lid defect with cantholysis (02:28)
    • Tenzel flap (03:35)
    • Repair of 40% full-thickness defect of the lower eyelid (02:35)
    • Repair of 50% of the lower eyelid (02:31)
    • Repair of 50% central full-thickness lower eyelid defect (06:54)
    • Repair of 50% lower eyelid defect with a periostal strip (05:37)
    • Free tarsal graft for repair of central lower lid defect (04:39)
    • Hughes Flap (tarsal-conjunctival flap) (05:14)
    • Second stage Hughes flap (01:39)
    • Repair of 100% lower eyelid defect (07:41)
  • Medial
    • Repair of full-thickness, medial, lower eyelid defect (02:55)
    • Repair of 50% medial full-thickness lower eyelid defect (07:03)
    • Composite flap for medial full-thickness eyelid defect (05:00)
  • Lateral
    • Repair of 50% lateral full-thickness lower eyelid defect (06:20)
    • Periosteal strip and mid-face lift for repair of lateral full-thickness defect (03:48)
    • Hughes flap with skin graft (04:18)
• Upper lid, full thickness
  • Repair of upper medial eyelid defect (02:26)
  • Repair of 50% upper eyelid defect with free tarsal graft and myocutaneous advancement flap (06:16) NEW
  • Repair of medial 50% upper eyelid full-thickness defect (06:18)
  • Repair of full-thickness upper eyelid defect (02:52)
  • Repair of 50% upper lid defect with a canthotomy/cantholysis (01:25)
  • Repair of upper eyelid defect with primary repair of posterior lamella and full-thickness skin graft (03:26)
  • Repair of large, lateral full-thickness upper lid defect (05:14)
• Lower lid, anterior lamella
  • Mustarde rotational flap (03:53)
  • Repair of large cheek defect with a combination of a Mustarde flap and skin graft (05:57)
  • Repair of large cheek defect with a rotational flap (04:29)
  • Myocutaneous flap for lateral lower lid defect (02:41)
  • Repair of small lateral lower eyelid defect (02:05)
  • Repair of inferior lateral anterior lamellar defect (02:32)
  • Combination of myocutaneous flaps for lower eyelid defect (03:38)
  • Full thickness skin graft (03:46)
  • Repair of lower lid/cheek defect with a full-thickness skin graft (03:45)
  • Two separate full thickness skin grafts (01:53)
  • Lateral rotational flap (02:14)
  • Full-thickness skin graft for lateral lower eyelid defect (02:04)
  • Myocutaneous advancement flap (02:17)
  • Repair of lower lid/cheek defect with a rhomboid flap (02:05)
  • O to Z Flap (01:17)
• Upper lid, anterior lamella
• Rhomboid flap (01:11)
• Upper eyelid advancement flap 1 (01:55)
• Upper eyelid advancement flap 2 (01:37)
• Pedicle flap from brow to upper eyelid (03:18)
• Multiple flaps for repair of upper eyelid anterior lamellar defect (02:25)
• Repair of defect involving the central brown and upper eyelid (02:37)
• Full-thickness skin graft to upper eyelid defect  (02:03)
• Full-thickness skin graft to the upper eyelid (02:13)
• Lateral canthus, anterior lamella
  • Lateral semicircular flap(semicircular rotational flap) (02:08)
  • Repair of a lateral canthal defect with an O to Z flap (01:50)
  • Repair of upper eyelid and lateral canthal defect (02:41)
  • Repair of lateral canthal defect (02:03)
  • Repair of a lateral canthal defect with a full-thickness skin graft (01:45)
• Medial canthus, anterior lamella
  • Combination mustarde and glabellar flap (03:47)
  • Median forehead flap with rotational flap (06:57)
  • Bilobe flap (01:57)
  • Glabellar flap (01:36)
  • Median forehead flap (03:48)
  • Median forehead flap with revisions (05:33)
  • Forehead flap for medial canthal defect (03:51)
  • Glabellar flap for medial canthal defect (03:31)
  • Rotational flap for medial defect (02:50)
  • Combination glabellar and rotational flaps for repair of medial canthal defect (05:31)
  • Para-median forehead flap (03:35)
  • Second stage median forehead flap (04:09)
  • Second stage median forehead flap with lid crease creation (04:01)

Harvesting of tissue

• Skin
  • Split thickness skin graft (02:12)
  • Full thickness skin graft harvested from the inside of the upper arm (01:16)
  • Full thickness skin graft from supraclavicular area (02:04)
  • Full thickness skin graft from retroauricular area (02:13)
  • Harvesting of preauricular skin graft (01:22)
  • Retroauricular skin graft harvest (02:28)
• Fascia/Muscle/Fat/Cartilage
  • Autogenous fascia harvest (02:30)
  • Close up of autogenous fascia harvest (02:11)
  • Muscle biopsy "Biopsy of vastus lateralis muscle" (03:06)
  • Harvesting of dermis fat graft (02:44)
  • Harvesting of ear cartilage graft (02:54)
• Mucous Membrane
  • Buccal mucous membrane harvest (02:19)
  • Harvesting of a hard palate graft (01:56)
  • Harvesting of a free tarsal graft (01:37)

Lid trauma

• Repair of full-thickness lower eyelid laceration (01:58)
• Repair of full-thickness upper eyelid laceration (02:58)
• Repair of lower lid canalicular laceration 1 (01:50)
• Repair of lower lid canalicular laceration 2 (03:18)
• Upper canalicular laceration repair (03:18)
• Repair of canalicular laceration with a pigtail probe (03:28)

TA biopsy

• Temporal artery biopsy (02:49)
• Temporal artery biopsy #2 (03:14)

Orbitotomy

• Anterior
• Excision of medial dermoid cyst (02:14)
• Excision of central dermoid cyst (02:27)
• Excision of lateral dermoid cyst (02:50)
• Excision of superior-lateral dermoid cyst (02:38)
• Excision of superior-temporal dermoid cyst (02:14)
• Excision of high superior lateral dermoid cyst (01:36)
• Lacrimal gland biopsy (02:05)
• Medial lid-split anterior orbitotomy (01:59)
• Transcaruncular access to the medial orbital wall (01:25)
• Transconjunctival anterior orbitotomy (02:13)
• Transconjunctival anterior orbitotomy for inferior lateral mass (02:10)
• Transconjunctival anterior orbitotomy for inferior rectus mass (02:46)
• Upper eyelid crease anterior orbitotomy (01:37)
• Excision of superior cystic lesion (02:44)
• Transconjunctival inferior-medial anterior orbitotomy (01:29)
• Transcutaneous inferior anterior orbitotomy (01:49)
• Biopsy of infraorbital nerve (02:42)
• Biopsy of supraorbital nerve (01:54)
• Anterior orbitotomy with inferior rim incision (01:41)
• Anterior orbitotomy for rhabdomyosarcoma (01:47)
• Anterior orbitotomy for suspected rhabdomyosarcoma (02:47)
• Transconjunctival medial anterior orbitotomy (02:32)
• Lateral
  • Lateral canthotomy incision for access to lateral orbit (01:52)
  • Lateral orbitotomy 1 (02:30)
  • Lateral orbitotomy 2 (01:32)
  • Lateral orbitotomy 3 (02:51)
  • Lateral orbitotomy with bone window (03:12)
  • Endoloop ligature for vascular malformation of the orbit (03:36)

ONSF (Optic nerve sheath fenestration)

• Optic nerve sheath fenestration (02:08)
• Optic nerve sheath fenestration (medial upper lid) #2 (03:46)
• Lateral approach for an optic nerve sheath fenestration (04:44)

Orbital decompression

• Left lateral orbital decompression (04:35)
• Left medial orbital decompression (03:43)
• Right lateral orbital decompression (03:37)
• Right medial orbital decompression (01:03)
• Right orbital floor decompression (01:47)

Orbital fracture repair

• Repair of orbital floor fracture #1 (02:30)
• Repair of orbital floor fracture #2 (04:21)
• Orbital floor fracture repair with placement of a porous polyethylene titanium implant (02:30)
• Repair of orbital floor fracture using headlight mounted cam (03:26)
• Orbital floor fracture repair with placement of Supremid implant (01:21)
• Repair of orbital floor fracture without canthotomy/cantholysis (01:41)
• Repair of large orbital floor and medical wall fractures with a combined trans-conjunctival and trans-caruncular incision (07:01)
• Implant placement for combined medial wall and orbital floor fractures (02:00)
• Removal of superior orbital rim fragment (02:39)
• Channel implant for orbital fracture repair (05:00)
• Removal of titanium mesh (00:41)

Enucleation

• Enucleation medial approach to the optic nerve (04:41)
• Enucleation with implant (04:26)
• Enucleation in an Infant (01:11)
• Enucleation of globe with extra-scleral extension of melanoma (03:59)
• Enucleation with dermis-fat graft for microphthalmos (05:05)
• Transection of oblique muscles during an enucleation (02:00)   

Evisceration

• Evisceration with placement of implant (03:11)
• Evisceration for endophthalmitis (03:55)
• Intraconal implant placement in an evisceration (01:00)
• Orbital implant exchange after evisceration (04:23)
• Evisceration in patient with type II Boston keratoprosthesis (04:12)

Exenteration

• Lid sparing exenteration (03:18)
• Exenteration with placement of a split thickness skin graft (05:14)
• Exenteration in patient with large adenoid cystic carcinoma (04:58)

Anophthalmic Socket

• Dermis fat graft in anophthalmos #1 (03:58)
• Dermis fat graft in anophthalmos #2 (03:20)
• Enophthalmos wedge implant (02:09)
• Repair of anophthalmic deformity with mid-face left, orbital augmentation, and periosteal strip (06:41)
• Scleral patch graft for exposed orbital implant (02:46)
• Scleral patch graft for exposed orbital implant #2 (02:37)
• Mucous membrane graft for lower fornix reconstruction (03:49)
• Orbital implant exchange (03:12)
• Removal of obital implants in a painful anophthalmic socket (03:10) 
• Implantation of a Bio-Eye orbital implant (01:55)

Additional oculoplastic surgery videos

 

• Cataract & Intraocular Lens Procedures
• Clinical Ophthalmology
• Cornea, External Disease, Refractive Procedures
• Glaucoma
• Iris
• Neuro-Ophthalmology
• Oculoplastics
• Optics and Refraction
• Pediatric Ophthalmology
• Retina & Vitreous
• Suturing and Tying Techniques
• Trauma
• Disclaimer, Copyright