Does ASOPRS Advise Scleral Contact Lenses Be Routinely Used to Protect the Globe?

A retired ophthalmologist, (Bascom Palmer trained, with 34 years of practice, including thousands of lid and facial cases, some lid reconstructions..eg reconstruction of outer 2/3 of lids plus outer canthus for BCC involving periosteum flaps, mucousal graft with Mustarde flaps), I was amazed to learn recently that elective lid surgery is being done without globe safety provided by scleral contact lenses, which also facilitates surgery, elevating, firming up the lid..heard of FT corneal cut.

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6 Doctor Answers | Asked by Nick Kalvin MD

Doctor Answers (6)
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We use these lens when they are needed.

Understand that oculoplastic surgeons are trained to operate on the eye itself as well as the eyelids. Therefore we do not need to routinely hide the globe from errant needles. There are certain maneuvers where the use of a hard contact lens is customary and beneficial. However this is an intraoperative decision made by the surgeon based on moment to moment considerations. Certainly there are many operative situations were the presence of the contact lens will make... more

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

No such recommendation

ASOPRS has no blanket recommendation for scleral contact lenses to be routinely used for eyelid surgery. As you know, ASOPRS trained Oculoplastic surgeons are also ophthalmologists that routinely work on ocular surface diseases and are very comfortable and skilled while operating around the eye and ocular structure. In addition, they are quite adept at treating ocular complications [most facial plastic surgeons and general plastic surgeons send us their complications and more difficult... more

A.J. Amadi, MD

14 reviews

Seattle Oculoplastic Surgeon

seattleface.com

Many surgeons use protective shields when operating

I use the Cox II metallic shields while operating, mainly to block out the bright surgical lighting, which causes patient discomfort. They have the benefit of protecting the eye surface as well from an errant cut. Thankfully I haven't experienced this type of complication, but it always pays to be safe. That being said, as an ophthalmologist and oculoplastic surgeon, I feel comfortable operating on the eyelids without the shields and often can't use them as they may impede... more

Matheson A. Harris, MD

6 reviews

Salt Lake City Oculoplastic Surgeon

www.utahoc.com

Lenses with eyelid surgery

This is the choice of the surgeon.I think it also depends on the type of procedure as well.Soem aptients may get a cornal abrasion from inserting the lenses so it is thedoctors choice.

Eyelid Surgery: Use of Corneal Shields

I completely agree with Dr. Steinsapir on this issue; I believe Dr. Shumway's seatbelt statement is debatable. Since I am not a member of ASOPRS, I cannot comment on their position, but I do not believe there is any blanket recommendation on corneal shields from any organization that considers cosmetic and reconstructive surgery of the eyelid part of their repertoire (ABFPRS, ABPS, etc.). I think that it is important to understand that use of corneal shields also carries risk and... more

ASOPRS

Low profile scleral and corneal protectors are routine and are a wise choice for all Facial Cosmetic Surgeons. I suppose those who drive without seat belts are just "asking" for it too!