This is a 26-old male who sought treatment for his left sunken eye with constant tearing from left eye. He had been diagnosed with a rare bone disease called fibrous dysplasia at the age of 12 years. In this disease, the bone is slowly replaced with fibrous tissue and the growth of the tissue assumes large proportion. For this patient, the disease was limited to only the orbital bone part. As the orbit (eye socket) bones were pressing the eye, 8 years back, a surgery was performed to relieve the pressure on the eyeball. The result of this surgery leads to improper positioning of the eyeball in the eye socket, resulting in sunken misplaced left eye. Also, as a result of the surgery, there was a constant overflow of tears from the left eye.
The current treatment plan is to correct, shape the orbit and position the eyeball correctly. All this procedure needs to be performed without affecting the vision and delicate optic nerve.
An upper eyelid incision was placed just below the upper eyebrow along previous scars. Through this incision and a sub-ciliary incison, the bone of the upper margin was shaped. All removed bone was carefully salvaged. Through an inferior medial canthus region, the lower eyelid region was approached. In the lower margin, preparation of the bone was done. Eye tissues were carefully dislodged at needed areas. The salvaged bones were placed and screwed. This gave a new, improved frame work for the orbit. The punctum of tear gland were identified.
A delicate silicon tube was carefully inserted and the blocks removed. The tube was retrieved through an artificial opening in to inferior nasal meatus in the nasal cavity. By the suturing of the ductal mucosa with the nasal mucosa, the patency is ensured. By this surgery called dacryocystorhinostomy (DCR), the tears are redirected in to nasal mucosa so that there is no excess tear overflow. A modified “Y” medial canthoplexy was performed to ensure the proper positioning of the eye socket and eyeball. This was a customized technique developed at BDCH. This results in perfectly looking eye socket and eyeball. After the procedure, all movements of eye ball indicated that there had been no damage to the functioning of eye, indicating the complete success of the surgery.
The current treatment plan is to correct, shape the orbit and position the eyeball correctly. All this procedure needs to be performed without affecting the vision and delicate optic nerve.
An upper eyelid incision was placed just below the upper eyebrow along previous scars. Through this incision and a sub-ciliary incison, the bone of the upper margin was shaped. All removed bone was carefully salvaged. Through an inferior medial canthus region, the lower eyelid region was approached. In the lower margin, preparation of the bone was done. Eye tissues were carefully dislodged at needed areas. The salvaged bones were placed and screwed. This gave a new, improved frame work for the orbit. The punctum of tear gland were identified.
A delicate silicon tube was carefully inserted and the blocks removed. The tube was retrieved through an artificial opening in to inferior nasal meatus in the nasal cavity. By the suturing of the ductal mucosa with the nasal mucosa, the patency is ensured. By this surgery called dacryocystorhinostomy (DCR), the tears are redirected in to nasal mucosa so that there is no excess tear overflow. A modified “Y” medial canthoplexy was performed to ensure the proper positioning of the eye socket and eyeball. This was a customized technique developed at BDCH. This results in perfectly looking eye socket and eyeball. After the procedure, all movements of eye ball indicated that there had been no damage to the functioning of eye, indicating the complete success of the surgery.
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