Hernawita Soeharko
Dr. Hernawita Soeharko is currently Consultant of Ophthalmic Plastic & Reconstructive Surgery, Jakarta Eye Center Hospital, Indonesia.
She is currently Head of Ophthalmic Plastic & Reconstructive Surgery Division, Department of Ophthalmology, Faculty of Medicine, University of Indonesia (2006–now).
She is the past Head of Indonesian Ophthalmic Plastic & Reconstructive Surgery & Eye Tumor Surgery Association.
She graduated from the Department of Ophthalmology University of Indonesia in 1994.
She studied oculoplastic and reconstructive surgery at Moorefield Eye Hospital, London in 1995.
She is also contributed in various International and National Ophthalmology meetings as participant, speaker as well as instructor in oculoplastic courses.
Darmayanti Siswoyo
Dr. Darmayanti Siswoyo is currently consultant of Ophthalmic Plastic & Reconstructive Surgery, Jakarta Eye Center Hospital, Indonesia.
She is the past Head of Ophthalmic Plastic & Reconstructive Surgery Division, Department of Ophthalmology, Faculty of Medicine, University of Indonesia.
She is also the past Head of Indonesian Ophthalmic Plastic & Reconstructive & Eye Tumor Surgery Association. She graduated from Department of Ophthalmology University of Indonesia in 1987.
She underwent orbital reconstruction training at Cranio Facial Center, Department of Plastic surgery, Royal Adelaide Hospital, South Australia in 1987.
She also underwent Oculoplastic & Reconstructive Surgery training at Department of Plastic Surgery, Kansai Medical Faculty and Department of Ophthalmology, Hamamatsu Hospital, Japan in 1992.
She is a Observer at Moorfield Eye Hospital London, England, 1993.
She is also National Speaker, Didactic Course Instructor, Wet Lab Instructor in Oculoplastic and Reconstructive Surgery in Indonesia since 1988 and International Speaker in Oculoplastic & Reconstructive Surgery since 1996.
Introduction
Eyelid avulsion is an injury in which the eyelid is forcibly detached from its natural position caused by trauma such as motor vehicle collisions, animal bites, and human bites. It can occur with or without eyelid tissue loss (Fig. 5.1a–c). Both of those conditions can lead to lacrimal pump disorders and corneal exposure with all of the consequences ranging from dryness of the cornea, exposure keratopathy, and ending with corneal perforation if not treated properly. Because the primary function of the eyelid is to protect the eyeball from the outside and because it is also an important part of the tear pump mechanism, surgical repair is required to manage eyelid avulsion and prevent exposure keratopathy. Exposure keratopathy due to avulsed/absent lids should be managed medically (see Chap. 29 “Management of Severe Exposure Keratopathy”); then as soon as possible, the avulsed/ absent lid should be repaired surgically to restore eyelid function. It is important to know about the basic rules of eyelid repair so that both cosmetic appearance and physiological function can be preserved [1, 2].
Fig. 5.1
(a) Eyelid avulsion without tissue loss. (b) Eyelid avulsion without tissue loss. (c) Eyelid avulsion with tissue loss (part of superior eyelid)
Treatment
Timing of Repair
Although optimum repair for eyelid injuries is within 24 h after their occurrence, these injuries can easily be repaired up to several days later.
But the best time to repair eyelid avulsion is as soon as possible, especially if eyelid avulsion is accompanied by tissue loss and resulting corneal exposure. In order to get the best result, the surgery should be done by an oculoplastic surgeon [3, 4].
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