Oculoplastics, Oculoplastics/Orbit, Pediatric Ophth/Strabismus

    Placement of a "high" or "supratarsal" weight has a number of advantages over a "low" or "pretarsal" weight. In this video, Dr. Richard Allen discusses these advantages and demonstrates the surgical technique for placement of a high platinum weight in a pediatric patient. After an incision is made along the eyelid crease marking, dissection is then carried out through the orbicularis muscle to the underlying orbital septum. The septum is opened and the preaponeurotic fat is dissected from the underlying levator aponeurosis. A 1.2-gram platinum weight is placed between the levator aponeurosis and the Mueller muscle in such a way that the inferior border is at the superior border of the tarsus. The weight is then sutured in.

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