教学录像分享：如何外眦切开

在眼睑整形下睑松弛的处理中会涉及到外眦切开。这项技术在术中及外伤球后出血等导致明显急性眶压升高危及视力(眼眶间隔综合征)时也会用到。这里分享一个外眦切开的教学录像。这是一种非常有用的眼科急救技术，应该掌握。

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I'm Dr. Jeff Mason. And this video shows illustrations and real footage of a lateral canthotomy. That's a procedure to release an orbital compartment syndrome. So if you have a bunch of pressure pushing on the eye, usually that's from a retrobulbar hematoma, that's a pocket of blood pushing the eye forward. We want to create an incision so we can basically let the eyeball come forward.

If you're only gonna remember one number, I want you to remember “40”. “40”. That's 40 . it's the intraocular pressure when you need to cut and release the compartment syndrome. Let's go through the steps of the procedure .

First step is you want to get it numbed up, so lidocaine was happy be a nice doctor.

Second you're gonna crush the lateral canthus with a clamp. This devascularized area. Now here it is in the real procedure,  you want to leave that clamp there for about one minute so it doesn't bleed like stink when you cut nuts coming up.

And step three, cut the lateral canthus you're gonna cut towards the orbital rim on the side.

Next,  you're gonna cut that lateral canthal ligament which has both a superior and inferior crus sort of looks like a wishbone on its side.  You want to cut down , cut that inferior crus first.  Sometimes this releases enough pressure on its own.  But if not , cut the superior crews.  Now it can be real hard to see even for you. Now just patient.  There's a lot of blood,  lousy stuff . So get in there with one of your instruments get some tactile feedback. It’s sort of feels like a guitar string. Yeah it was like it's done . At the end recheck your inter ocular pressure to make sure it dropped and this is how it should look when you're done.