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Treatment of Epiphora Owing to Flaccid Eyelids

Treatment of Epiphora Owing to Flaccid Eyelids Abstract • Flaccid eyelids commonly have a history of gradual onset of epiphora, which is aggravated by cold weather and wind. The natural history starts in middle age; as age increases, flaccidity increases. When the flaccid eyelids are surgically improved by a lateral canthal tendonesis, epiphora is greatly diminished. The surgical technique of tenodesis is accomplished by making an 18-mm skin incision at the lateral canthus. The pretarsal and preseptal portions of the orbicular muscle are mobilized, and the raphe is incised. The lateral canthal tendon is dissected and a 2-0 black silk suture is orthopedically placed so it pulls the tendon into a drilled hole near Whitnall's orbital tubercle. Cautery is applied to the cut ends of the upper and lower mobilized muscle. The pretarsal and preseptal muscles are resected 5 mm. The skin is approximated and the 2-0 suture is tied over a button and left in place for six weeks. References 1. Hill Joseph C: Analysis of senile changes in the palpebral fissure . Trans Ophthalmol Soc UK 95 ( (pt 1) ):49-53, 1975. 2. Dalgleish R, Smith JLS: Mechanics and histology of senile ectropion . Br J Ophthalmol 50:79-92, 1966.Crossref 3. Bick MW: Surgical management of orbital tarsal disparity . Arch Ophthalmol 75:386-389, 1966.Crossref 4. Stasior OG, Hill JC: Dacryocystometry. Presented at the American Academy of Ophthalmology and Otolaryngology meeting, Las Vegas, 1976. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Treatment of Epiphora Owing to Flaccid Eyelids

Hill, Joseph C.
Archives of Ophthalmology , Volume 97 (2) – Feb 1, 1979
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References (4)

Publisher
American Medical Association
Copyright
Copyright © 1979 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1979.01020010169018
Publisher site
See Article on Publisher Site

Abstract

Abstract • Flaccid eyelids commonly have a history of gradual onset of epiphora, which is aggravated by cold weather and wind. The natural history starts in middle age; as age increases, flaccidity increases. When the flaccid eyelids are surgically improved by a lateral canthal tendonesis, epiphora is greatly diminished. The surgical technique of tenodesis is accomplished by making an 18-mm skin incision at the lateral canthus. The pretarsal and preseptal portions of the orbicular muscle are mobilized, and the raphe is incised. The lateral canthal tendon is dissected and a 2-0 black silk suture is orthopedically placed so it pulls the tendon into a drilled hole near Whitnall's orbital tubercle. Cautery is applied to the cut ends of the upper and lower mobilized muscle. The pretarsal and preseptal muscles are resected 5 mm. The skin is approximated and the 2-0 suture is tied over a button and left in place for six weeks. References 1. Hill Joseph C: Analysis of senile changes in the palpebral fissure . Trans Ophthalmol Soc UK 95 ( (pt 1) ):49-53, 1975. 2. Dalgleish R, Smith JLS: Mechanics and histology of senile ectropion . Br J Ophthalmol 50:79-92, 1966.Crossref 3. Bick MW: Surgical management of orbital tarsal disparity . Arch Ophthalmol 75:386-389, 1966.Crossref 4. Stasior OG, Hill JC: Dacryocystometry. Presented at the American Academy of Ophthalmology and Otolaryngology meeting, Las Vegas, 1976.

Journal

Archives of Ophthalmology – American Medical Association

Published: Feb 1, 1979

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