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manojkumar2127224
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The patient was prepped and draped. The lower lids were marked out with a marking pen, especially in the lateral canthus. The lateral canthus was marked out in a convenient wrinkle. The skin in the subciliary incision site was injected with an anesthetic solution of 2% Xylocaine and 1:100,000 epinephrine along with one ampule of Wydase per 60 mL of anesthetic solution.
An orbital block was done. An infraorbital block was also performed with a 25 gauge needle. A skin muscle flap was elevated by sharp dissection down to the orbital rim area. The herniated periorbital fat was removed by opening the orbital septum with sharp dissection using a 15 blade, teasing the periorbital fat out, cross clamping the fat and removing the fat with a scissor over the clamp. The clamp was cauterized with needle cautery and then the clamp was scarped with a 15 blade.