By Patricio A. Pacheco
It is a complete, functional guidebook that gives a transparent assessment and replace of present smooth strategies of ocular surgical procedure. The chapters can be of curiosity to a large viewers. The chapters are written by way of specialists with distinctive curiosity and wide scientific adventure within the themes.
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The difference with the previously described technique is that the skin incisions are placed 2 mm above the lash line and are joined at the medial and lateral canthus. Dissection is carried out in the preseptal plane or in the preorbicularis plane. We prefer the preseptal plane; it is easy to follow and allows a good blood supply to the future granulation tissues. In conclusion, with this procedure, we partly cover the orbital bones, and we add a vascular supply to our skin flap, reducing the time the socket needs to granulate.
Synthetic tissue Polyglactin 910 mesh (Vicryl mesh, Ethicon, Sommerville, NJ, USA) is used to wrap hydrox‐ yapatite and bioceramic orbital implants. It offers a series of advantages: there is no risk of disease transmission, there is no need of a second surgical site, and it is easy to use. It has a porous structure that allows fibrovascular ingrowth . Polytetrafluoroethylene and polyglicolic acid (Dexon mesh style no8, Davis & Geck, Manati, Puerto Rico) have also been used as implant cover materials.
Orbital implants Evisceration and enucleation result in an empty cavity and aesthetic problems for the patients that we should try to avoid. We must be sure that the patient fully understands the information given about the surgery and expected results in order to obtain the informed consent. Once this is done, the surgeon will decide the type of orbital implant, which can be placed primarily or secondarily in another surgery. The implant can be made of synthetic material, autologous material, or eye-banked tissues.
Advances in Eye Surgery by Patricio A. Pacheco