No dressings are used after surgery. The patient is instructed to apply ice cold compresses on the eyelids. Pads 4 by 4 inches, soaked in a buckle of saline and ice are applied with slight general pressure to the lids. When the pads become warm, they arc dipped again into the saline and ice and reapplied. This process is repeated for 24 hours. The application should be fairly constant for the few postoperative hours. After that the compresses are applied for about 15 minutes with a 15-minute rest period in between until bedtime. The applications are resumed on awakening.
To reduce edema postoperatively the patient lies in bed with the head approximately 45° higher than the rest of the body. Nurses should check for bleeding associated with proptosis, pain, or loss of vision every 15 minutes for the first two to three hours postoperaÂtively or until the patient leaves the surgical facility. Every hour thereafter until bedtime, the family or patient should monitor the patient’s ability to count
fingers and should check for residual proptosis and pain. If the patient cannot count fingers or has marked proptosis or pain, the family should take him or her to the emergency room. If loss of vision occurs secondary to retrobulbar hemorrhage, it could easily be detected by opening the incision involved.’ Garamycin ointment is applied to the eyes twice a day for the first two weeks.
No dressings are used after surgery. The patient is instructed to apply ice cold compresses on the eyelids. Pads 4 by 4 inches, soaked in a buckle of saline and ice are applied with slight general pressure to the lids. When the pads become warm, they arc dipped again into the saline and ice and reapplied. This process is repeated for 24 hours. The application should be fairly constant for the few postoperative hours. After that the compresses are applied for about 15 minutes with a 15-minute rest period in between until bedtime. The applications are resumed on awakening.
To reduce edema postoperatively the patient lies in bed with the head approximately 45° higher than the rest of the body. Nurses should check for bleeding associated with proptosis, pain, or loss of vision every 15 minutes for the first two to three hours postoperaÂtively or until the patient leaves the surgical facility. Every hour thereafter until bedtime, the family or patient should monitor the patient’s ability to count
fingers and should check for residual proptosis and pain. If the patient cannot count fingers or has marked proptosis or pain, the family should take him or her to the emergency room. If loss of vision occurs secondary to retrobulbar hemorrhage, it could easily be detected by opening the incision involved.’ Garamycin ointment is applied to the eyes twice a day for the first two weeks.
No dressings are used after surgery. The patient is instructed to apply ice cold compresses on the eyelids. Pads 4 by 4 inches, soaked in a buckle of saline and ice are applied with slight general pressure to the lids. When the pads become warm, they arc dipped again into the saline and ice and reapplied. This process is repeated for 24 hours. The application should be fairly constant for the few postoperative hours. After that the compresses are applied for about 15 minutes with a 15-minute rest period in between until bedtime. The applications are resumed on awakening.
To reduce edema postoperatively the patient lies in bed with the head approximately 45° higher than the rest of the body. Nurses should check for bleeding associated with proptosis, pain, or loss of vision every 15 minutes for the first two to three hours postoperaÂtively or until the patient leaves the surgical facility. Every hour thereafter until bedtime, the family or patient should monitor the patient’s ability to count
fingers and should check for residual proptosis and pain. If the patient cannot count fingers or has marked proptosis or pain, the family should take him or her to the emergency room. If loss of vision occurs secondary to retrobulbar hemorrhage, it could easily be detected by opening the incision involved.’ Garamycin ointment is applied to the eyes twice a day for the first two weeks.
Complications
Several patients in whom I performed the transconÂjunctival approach had postoperative residual derma-tochalasis, which needed to be removed through an external approach or a laser skin resurfacing. Better patient selection or combined initial procedure with skin flap excision or orbicularis muscle plication could have prevented this problem.
Although this procedure has not caused any motility problems, in several patients in whom this procedure was combined with a tarsal strip procedure, ocular
