Ptosis Surgery Arnab Biswas
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1PTOSIS SURGERY2
3PTOSIS SURGERY
Arnab Biswas FRCS Consultant oculoplastic and orbital surgeon Alo eye care, Kolkata, West Bengal, India Foreword Prof J.R.O. Collin
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Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
Corporate Office
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Ptosis Surgery
© 2010, Jaypee Brothers Medical Publishers (P) Ltd.
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
First Edition: 2010
9788184489637
Typeset at JPBMP typesetting unit
Printed at Ajanta Offset
5Dedicated to
my wife, Sejuti, who has still been by my side, after all these years tolerating my whimsical self and my son, Rudra, who is my source of inspiration6
7Foreword
This is the best book on ptosis surgery that I have read since the last edition that Crowell Beard wrote on this subject many years ago. In fact it is the long awaited successor to Crowell Beard's work written very much in the same style with excellent diagrams, surgical drawings and operative photographs. It does however have many innovative additions such as lists of drugs that have been reported to induce ptosis, syndromes and diseases associated with ptosis and a sample “hand-out” for ptosis patients.
There are ten very clearly presented chapters covering anatomy, surgical dissection, classification, clinical evaluation, types of ptosis and treatment, decision making in ptosis surgery, surgical procedures, surgery of associated conditions, complications and, finally, anesthesia and instruments. The text is set out in easily readable paragraphs with appropriate headings and annotations which make it very easy to follow and reference. The subject matter is accurate, comprehensive and very uptodate including the latest information on genetics, tests such as for myasthenia and recently described procedures.
This book could well be described as “everything you need to know about ptosis surgery”. It should be an essential addition to every surgeon's library who practices or wants to know about ptosis and its correction. The author very successfully has achieved his aim of producing a worthy and current successor to Crowell Beard's great treatise on ptosis surgery.
Prof J.R.O. Collin
MA MB Bchir FRCS FRCOphth DO
Consultant Oculoplatic Surgeon
Member of the Advisory Board to the International Council of Ophthalmology
Moorfields Eye Hospital and
Institute of Ophthalmology
University of London
London, UK
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9Preface
Ptosis surgery is a fascinating mixture of science and art. With its vast canvas, it takes a lifelong experience to learn its intricacies. However, all the efforts and frustrations of learning experience are overcome by the smiles and gratitude of the patients you meet along the way.
Ptosis is probably one of the most common oculoplasty case that one encounters. Every ophthalmologist dreams or wishes that if I could have done something for the patient. But at the back of the mind it plays; am I doing the right thing? what surgery to do? and what will I do if I have a complication?. Where do I look for all this situations?
The aim of this book is to help all budding ophthalmologists as well as practising clinicians, to act as a reference manual on the art and science of ptosis evalution. It is aimed to help them take decisions regarding a ptosis patient, treat him and manage complications.
In this book I have tried to distribute the chapter in such a way so that one first becomes acquainted with the surgical anatomy of the lids then clinically evaluate a ptosis patient, and ultimately, takes necessary decisions on when, what and how to treat a patient.
Once surgery has been planned, the different surgical techniques have been described in details, first with sketches, then with actual surgical photographs in step by step fashion, to help all have a feel of the how each tissue looks like on the operating table.
The book also covers the surgical management of other associated conditions like telecanthus, epicanthus, ectropion, etc. that also needs to be simultaneously managed in some situations when associated with ptosis. The other important section deals with the complications following ptosis surgery and their remedies in detail. This is a comprehensive text atlas through the beautiful and challenging world of ptosis. I hope this small endeavor instills in all budding ophthalmologist the willpower to say that yes I can also diagnose the condition and do the necessary surgical procedure.
This book would have remained in the archives, had it not been taken initiative for publishing by Mr JP Vij, CEO of M/s Jaypee Brothers Medical Publishers (P) Ltd., New Delhi. He has been encouraging and helping with suggestions all along the process from conceptualizing this project to making it a reality.
In trying to cover such a challenging topic, there will be some omissions and flaws. I would welcome advices, suggestions as well as comments from all those who read this book. This will help us produce better results in future.
Arnab Biswas
10Acknowledgments
I especially acknowledge to those who have been the lifeline during the process of writing and production of this book:
Saumik Chakraborty for Cover Design
Rumki Chakraborty and Ayan Chakraborty for Medical Illustrations
Siddhartha Mukherjee for Sketch Illustrations and
Rajib Sarkar for graphic Designs