Abstract
Lacriserts, punctal occlusion, and plastic dressings are adjuncts to corneal lubrication in the immediate post-operative period for patients with dry eyes, corneal compromise, or transient lagophthalmos following ptosis surgery.
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In patients with dry eyes, a Lacrisert pellet (Aton Pharma) can be placed in the inferior fornix at the conclusion of the case, in addition to lubricating ointment. Punctal occlusion can also be performed. Gentle cautery to the lower punctum, or insertion of a short piece of absorbable suture (if used during wound closure) in the lower punctum, are cost-effective temporary alternatives to traditional punctal plugs.
In patients with immediate postoperative lagophthalmos, a Tegaderm (3M, IV Site Secural) or Opsite (Smith & Nephew) plastic dressing is an adjunct to lubricating ointment (Airiani et al. 2003). The non-abrasive plastic dressing can be used until local anesthetic on the orbicularis muscle resolves, or overnight in patients who have difficulty instilling lubricating drops, or for patients with compromised corneas. The inferior portion of the plastic dressing can be crimped to make a channel for blood to seep through. Cold compresses can still be applied through this thin plastic dressing.
Reference
Airiani S, Braunstein RE, Kazim M, Schrier A, Auran JD, Srinivasan BD. Tegaderm transparent dressing (3 M) for the treatment of chronic exposure keratopathy. Ophthal Plast Reconstr Surg. 2003;19:75–6.
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Ing, E. (2015). Postoperative Care for Dry Eye Prevention in Ptosis Surgery. In: Hartstein, MD, FACS, M., Massry, MD, FACS, G., Holds, MD, FACS, J. (eds) Pearls and Pitfalls in Cosmetic Oculoplastic Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1544-6_190
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DOI: https://doi.org/10.1007/978-1-4939-1544-6_190
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