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Orbital Surgery

Orbital Surgery Beverly Hills

ORBITAL SURGERY
OVERVIEW

The orbit refers to the boney socket in the skull that contains the eye and all of the vital structural components to support proper eye functioning (i.e. muscles, blood vessels, and nerves). Although the orbit is surrounded by a layer of fat for protective cushioning, the eye socket is still susceptible to a variety of problems and potential injuries which, if left untreated, may have a detrimental impact on the function of the eye.

 

 

Common orbital conditions include:

  • Orbital or Lacrimal Tumors: this category of orbital condition includes cavernous hemangiomas (blood vessel malformation where a collection of dilated blood vessels form a tumor) and orbital or frontal sinus mucoceles (fluid-filled cysts that can expand or push into the eye socket, displacing the eye)
  • Complications stemming from inflammatory diseases, such as thyroid-associated orbitopathy (thyroid eye disease), as seen in patients with Graves’ disease and other types of inflammatory processes.

  • Orbital fractures: typically occurring as a result of mild or severe facial trauma, orbital fractures should be repaired promptly to prevent the eye from healing without compromising function or appearance. It is also possible to improve fractures that were left untreated in the past.

Before & Afters


before-after

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The aforementioned orbital conditions require careful assessment and detailed imaging to determine the optimal treatment plan. Orbital diseases are often associated with alarming signs and symptoms, including: pain, swelling, eye prominence, double vision, and/or loss of vision. Evaluation with a trained specialist is critically important to ensure appropriate evaluation, diagnosis, and treatment of the underlying problem.

As a highly experienced oculofacial surgeon, Dr. Kenneth Steinsapir possesses the necessary surgical skillset and in-depth knowledge of the intricate eye structures to perform safe and successful orbital skull-based surgery. Dr. Steinsapir’s private practice is located in beautiful Beverly Hills, CA, where he specializes in personalized reconstructive eyelid surgery procedures and has a proven track record of producing successful orbital surgery outcomes.

Dr. Steinsapir takes great to care to camouflage any orbital surgery incisions, inconspicuously hiding them within the eyelid crease, or employing a surgical approach from behind the eyelids. For example, he may avoid an eyelid incision to approach an orbital rim dermoid, instead using an endoscopic approach from behind the hairline. A personal consultation with Dr. Steinsapir is necessary to determine the best approach to address the orbital changes you are experiencing. You are encouraged to bring copies of any imaging studies that have been performed prior to your initial consultation.

 

ANOPTHALMIC SOCKET

In severe cases, trauma and disease may necessitate the removal of an eye, creating an anophthalmic socket (a socket without an eye). Eye removal surgery is often recommended when the eye has lost all useful vision and has become a blind, painful eye. The removal of an eye may take place soon after a sudden trauma, following the discovery of an intraocular tumor, or after an extended struggle to preserve a diseased eye. The removal of an eye is always the option of last resort. A second opinion is advisable if there are any questions about the best course of action.

If an eye is blind, but otherwise comfortable, eye removal is generally not recommended. In this circumstance, cosmetic issues can be addressed and (in most cases) rectified with a custom contact lens or scleral shell that has been fabricated by an ocularist. However, when a blind eye becomes painful, removal by enucleation or evisceration is generally recommended.

  • Enucleation: refers to the removal of the entire eye and the insertion of an intraconal implant into the eye socket. The extraocular muscles can be reattached to the intraconal implant to restore any volume lost when the damaged eye is removed. Once the socket has healed, an ocularist will fabricate an acrylic prosthetic piece to fit behind the eyelids, referred to as a “glass eye.”

  • Evisceration: an evisceration surgery involves the removal of the cornea and the contents of the eye, but leaves most of the eye wall or sclera intact. The advantage of this procedure is that it causes less disruption to the orbital tissues and results in more natural movement of the acrylic prosthetic. An evisceration procedure is generally the preferred surgical technique for eye removal, barring any specific circumstances that may favor enucleation.

COMPLICATIONS WITH AN ANOPTHALMIC SOCKET

A number of factors may contribute to the need for revisional surgery on the anophthalmic socket (socket without an eye). In recent years, there has been a push toward integrated intraconal implants that are comprised of hydroxyapatite. Unfortunately, these implants are often not well-tolerated, resulting in exposure of the implant and the need for revisional surgery.

In other cases, when the initial orbital implant is too small, there is inadequate replacement of orbital volume. Although the ocularist may attempt to compensate for this by constructing a larger prosthesis, the weight of the oversized prosthesis can gradually stretch the eyelids, potentially triggering the development of secondary orbital and eyelid issues, including chronic discharge and difficulty retaining the prosthesis.

When diagnosing and treating complications pertaining to anopthalmic sockets, Dr. Steinsapir employs his extensive ocular surgery expertise and takes great care to select the least invasive, yet still highly effective, treatment measures. During your initial consultation, Dr. Steinsapir will perform a thorough medical evaluation before designing a rehabilitative treatment plan to address the issues affecting the appearance, comfort, or hygiene of your socket.

Orbital Surgery Beverly Hills & Los Angeles

Dr. Steinsapir is a UCLA- and University of Chicago-trained surgeon who has performed separate fellowships in both Cosmetic Surgery and Oculofacial Microsurgery. He is board certified in Ophthalmology. Many individuals travel nationally and internationally to undergo orbital skull-based surgery or surgical repair of an anopthalmic socket with Dr. Steinsapir. For additional information on these reconstructive eye surgery procedures, or to inquire about any facial reconstructive concerns, please contact our office.

You may also continue to explore Dr. Steinsapir’s website (www.Lidlift.com), where you will find supplementary information pertaining to orbital surgery, anopthalmic socket repair, and other reconstructive eyelid procedures. You may also view our extensive portfolio of before-and-after reconstructive eyelid surgery case studies, and obtain answers to frequently asked questions about these procedures. Your reconstructive eyelid surgery can serve as a key stepping stone along the path to become the best possible version of yourself, and you can take the first step by calling to schedule your personal consultation with Dr. Steinsapir today.

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