Transconjunctival blepharoplasty

Abstract

Introduction. Initially titled in 1818 by Graefe, blepharoplasty is currently one of the most commonly performed aesthetic procedures but is still regarded as a technically challenging operation that requires a thorough understanding of the anatomy and function of the eyelids.The goals of lower eyelid blepharoplasty are to correct the characteristic signs of aging that occur in the periorbital region, including excess eyelid skin, lid laxity, and orbital fat malposition.Transconjunctival blepharoplasty allows access to the orbital fat through an incision through the lower conjunctiva and the capsulopalpebral fascia without any disturbance to the skin and orbicularis muscle of the lower eyelid. This approach avoids violation of the lower orbital septum, which can lead to less postoperative retraction of the eyelids, scleral spectacle and changes in the shape of the opening, which can complicate the transcutaneous approach. Transconjunctival blepharoplasty is indicated in the case of excess infraorbital fat, which gives the appearance of bags under the eyes of cyanotic shade, affecting the patient's image. It is also indicated in patients with infraorbital fat in combination with moderate laxity of infraorbital skin tissue. Dry eye exposure is a risk of any surgical manipulation of the upper or lower lids. Patients who have undergone corrective vision procedures such as laser in situ keratomileusis (LASIK) or keratotomy have an increased risk of dry eye problems and should be cleared for further surgery by their refractive eye surgeon. Patients wearing contact lenses pose a particular risk when blepharoplasty is considered. Eyes may dry out as a patient ages, and this process is often hastened by chronic contact lens use. Additionally, eyelid surgery such as blepharoplasty, canthopexy, or other lid altering procedures may subtly affect the curvature of the cornea, making use of contact lenses uncomfortable or even dangerous. Patients should discontinue the use of contact lenses weeks before surgery and not restart use for several weeks postoperatively to allow healing without any eyelid manipulation.The purpose of lower eyelid blepharoplasty is to rejuvenate the lower eyelid while maintaining a natural, unoperated appearance. Successful lower eyelid blepharoplasty depends on knowledge of anatomy and surgical techniques, accurate preoperative analysis, and attention to detail. Common problems of the lower eyelid, such as malarial descent, tear deformity, pseudo-herniated fat, eyelid laxity and changes in skin texture, as well as dermatochalasis and festoons should be recognized. Aim of study. Exposition of a narrative synthesis of contemporary literature and patient study. Methods and materials. In order to achieve the stated objective, the initial search of the specialized scientific literature, identified by the search engine Google Search and from the PubMed and Medscape databases, as well as the analysis of the statistical data at the TerraMed Private Hospital or. Chisinau, 2018-2021. The criteria for selecting the articles included the cross-conjunctival method of approaching the lower eyelid, indications, contraindications, beneficial methods.For the advanced selection of bibliographic sources, they were applied by filters: 2018-2021. After a preliminary analysis of the titles, original articles, editorials, articles of narrative synthesis, systematic and meta-analysis were selected, which contain relevant information and contemporary concepts about transconjunctival blepharoplasty, topographic anatomy, indications, contraindications, surgical description. The information from the publications included in the bibliography was gathered, classified, evaluated and synthesized, highlighting the main aspects of the contemporary vision on transconjunctival blepharoplasty. In order to minimize the risk of systematic errors (biases) in the study, through searches of the databases were performed to identify a maximum number of publications relevant to the purpose of the study. Only studies that meet the inclusion criteria were evaluated. We also analyzed both research that shows a positive result and research that does not show a beneficial effect on the intervention. Results. For the collection of the study group, I collected information about the patients who underwent the transconjunctival blepharoplasty operation, 2018-2021, TerraMed private hospital. According to the 2018-2021 study years, 26 transconjunctival blepharoplasty surgeries were performed in order to remove the excess of ptotic adipose tissue from both lower eyelids. Conclusion. Transconjunctival blepharoplasty allows the removal of excess fat from under the eyes, by making an incision inside the lower eyelid, this hides any scars and results in a look as natural as possible. Analyzing the results obtained from the study performed on patients who underwent transconjunctival blepharoplasty, we conclude that the age of the patients who go to the surgeon to remove excess ptosis adipose tissue of the lower eyelids demonstrates the importance not only of aesthetic but also eye comfort.