Biomedical subjects
Publications and source records attributed to S Morax.
A simple technique for resection of the superior tarsal muscle through a cutaneous approach, for the surgical treatment of ptosis, was employed in severe or moderate, congenital and acquired forms of the affection. Muller's muscle and the aponeurotic fascia are removed in a single piece, while conserving the tarsus.
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Reconstruction of the normal internal angle after injury raises the problem of conservation of the lacrimal pathways and the fixation of this angle when the ligament has been sectioned. Emergency treatment for the main types of lesion encountered are discussed. Superficial and deep lacerations require careful suturing in three planes and reconstruction of the lacrimal pathways; evulsions and tears should be treated by blepharopexy after determining the conjugated points; evulsion of the internal angle is often associated with an orbitonasal dislocation and has to be treated by transnasal internal canthopexy.
Cicatricial ectropions arise following burns, certain dermatoses, trauma with subsequent development of vicions scar tissue, and after evulsion of the eyelids. Operations on the ocular globe or eyelids may also lead to a cicatricial ectropion, while skin retraction during the advanced stages of ectropion due to hypotonia and congenital ectropions have to be considered as a separate group. Surgical treatment consists of correcting the skin deficiency by means of flaps or grafts, and reconstituting the internal angle when necessary. The principal surgical techniques and the types of flaps employed are described, as well as the indications for therapy as a function of the clinical form.
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The authors describe the surgical procedure employed in a case of bilateral cicatricial ectropion (superior and inferior), occurring during the course of a lamellar icthyosis. Total skin homografts should be applied before the appearance of severe corneal lésions on both eyelids, inferior and then superior. Two factors have to be emphasized: the apparent appearance of rejection of the grafts when the first dressings are made, and the progressive retraction of the homografts which requires repeated graft applications.
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