Vertical lid split procedure

Overview

• The vertical lid split procedure is an alternative to the traditional lateral canthotomy and allows for equally effective and most likely easier method of orbital decompression.

• Originally described as a surgical approach for gaining anterior access to the orbit for patients with ocular tumors the process has less steps and less landmark distortions in patients with orbital compartment syndrome. By making an 5mm long incision through the upper and lower eyelid on the lateral third, the orbit can move more anteriorly and emergently relieve pressure caused by an retro-orbital hematoma.

Indications

• Orbital compartment syndrome

Contraindications

• Globe rupture

Equipment Needed

• Foreceps
• Iris Scissors
• Sedation (if time permits)

Procedure

A full-thickness vertical incision is made at the junction of the later 1/3 of the upper and lower eyelid.

Complications

• Incomplete incision through the eyelid
• Iatrogenic globe or surrounding structure injury (rare)
• Bleeding

See Also

• Canthotomy