Oculoplastic Surgery Techniques
Richard C. Allen, MD, PhD, FACS
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
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
- Cicatricial
Lower lid entropion
- Involutional/spastic
- 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)
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
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
- Lateral
- Central
- 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)
Lacrimal surgeries
- Punctal procedures
- Canalicular procedures
- Treatment of canaliculitis (01:31)
- Canaliculotomy for canaliculitis (01:16)
- Excision of canaliculi (02:36)
- Canalicular cut-down for punctal stenosis (02:44)
- Evaluation and treatment of lacrimal dysgenesis (04:11)
- Double stent intubation for canalicular obstruction (04:20)
- Removal of intracanalicular plug (02:45)
- Crawford stent rescue (02:40 )
- Nasolacrimal duct procedures
- Mucoid reflux from lacrimal sac (00:59)
- Lacrimal sac stones (02:05)
- Cutaneous lacrimal fistula (00:31 )
- Inferior turbinate infracture (00:28)
- Probing and stenting (03:26)
- Probing and stenting of nasolacrimal duct with fluorescein irrigation (02:05)
- Options for retrieving Crawford stents (02:20)
- Endoscopic retrieval of Crawford stent (02:17)
- Intranasal cyst in congenital NLDO (01:04)
- External dacryocystorhinostomy (05:41)
- External dacryocystorhinostomy (DCR) #2 (06:31)
- Bilateral external dacryocystorhinostomy (02:15)
- Application of local anesthesia for a DCR (01:31)
- Endoscopic dacryocystorhinostomy (DCR) (03:01)
- Endoscopic dacryocystorhinostomy (DCR) #2 (03:01)
- Jones Tube Procedures
- Jones tube exchange (01:45)
- Jones tube placement #1 (03:05)
- Jones tube placement #2 (02:31)
- Jones tube placement #3 (01:19)
- Jones tube placement ("crescent twist") (01:14)
- Lacrimal gland biopsy and repositioning (03:06)
- Biopsy of granulomatous lacrimal gland inflammation (01:54 )
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
last updated: 12/11/2017
