New surgical techniques for reconstruction of the lid margin

The lid margins are extremely important to the health of the ocular surface. They play a major role in the distribution of the tear film over the eye. It is therefore important that disease of the eyelid margins be controlled before significant scarring of the ocular surface occurs. Two or three rows of eyelashes are present in the upper eyelid margin and one or two rows of eyelashes in the lower one. The tarsal plates include the meibomian glands. The objectives of eyelid margin surgery are both functional and cosmetic. Structural eyelid margin defects should be corrected with surgical techniques that return the anatomy to as close to normal as possible. Upper eyelashes should be preserved during the surgical procedures because defects of eyelashes in the upper eyelid are very visible. Restoring normal three dimensional anatomy (good lid contour, continuity of the lashes, etc) allows the eyelid margins to keep their functions for ocular surface protection and tear film distribution and gives optimal cosmetic result. In the time we will have in this session, we will seek to focus on the up to date surgical techniques that can be employed to correct inherited or acquired eyelid margin structural defects.