TarSys Slideshow - Dr. Robert A. Weiss

Robert A. Weiss, MD, FACS

Robert A. Weiss, M.D, F.A.C.SRobert A. Weiss, M.D, F.A.C.S

• Clinical Associate Professor University of Illinois at Chicago

• Director, Oculofacial Plastic and Reconstructive Surgery, Ophthalmic Oncology and Orbital Disease Advocate Illinois Masonic Medical Center

• Senior Partner Chicago Eye Institute


Robert A. Weiss, M.D, F.A.C.SRobert A. Weiss, M.D, F.A.C.S

Copyright by Robert A. Weiss, M.D. 2009. All rights reserved. This work, in whole and in each part, may not be reproduced and/or stored in any manner or with any device without the express written permission of the author.


TarSysEyelid Reconstruction





• Bioengineered Eyelid Spacer Graft• Rehydrate in Sterile Saline 20 Minutes Before Use




• 10 mm x 40 mm




• Severe Cicatricial Left Lower Lid Retraction & Upper Lid Ptosis (s/p 6 Prior LL Reconstructive Procedures)

• Note Left Lagophthalmos Secondary to LLL Retraction




• Standard Subciliary Approach




• Skin-Orbicularis Muscle Flap




• Inferior Boarder of Tarsus Delineated




• Elevate Septum - Lower Lid Retractors




• Removal of Previously Placed Spacer




• Lateral Tarsal Strip - Lateral Orbital Tubercle- Supra-Placed Above Tubercle




• TarSys Attached to Medial Deep Tissues - Medial Canthal Tendon




• TarSys Attached To Tarsus Above and Recessed Lower Eyelid Retractors Below




• TarSys Attached To Tarsus Above and Recessed Lower Eyelid Retractors Below




• Limited Mid-Face Lift or Adjacent Tissue Transfer or Full-Thickness Skin Graft if Outer Lamellar Vertical Soft Tissue Shortage







• Note Symmetry of Lower Lid Position Relative to Inferior Limbus




• Intra-Operative - Right Lower Lid Repair with TarSys Inner Lamellar Reconstruction and Mid-Facelift Outer Lamellar Reconstruction




• Bilateral Lower Lid Repair with TarSys Inner Lamellar Reconstruction and Mid-Facelift Outer Lamellar Reconstruction




• Left Lower Eyelid Retraction S/P Emergency Room Physician Primary Repair

• S/P Secondary Repair with Lateral Tarsal Strip, TarSys Graft and Adjacent Tissue Transfer




• Eyelid Retraction Maxillary Hypoplasia and Prior Blepharoplasty with Secondary Mechanical and Inner Lamellar Cicatricial Lower

• S/P Lateral Tarsal Strip with TarSys Graft and Limited Mid-Facelift




• Lagophthalomos Associated with Lower Eyelid RetractionMaxillary Hypoplasia and Prior Blepharoplasty

• S/P Lateral Tarsal Strip with TarSys Graft and Limited Mid-Facelift




• Primary Highly Malignant Merkel Cell Tumor




Cut Edge of Orbicularis Muscle, (Aponeurosis Removed En Bloc with Neoplasm)




Whitnall’s Ligament

Superior/Forniceal Conjunctiva

Lacrimal GlandCut Edge of Levator Just Above Aponeurosis Junction




Conunctiva Deep To Tarsys - Anchored on Anterior Surface of Graft

Levator Muscle Anchored to Superior Edge of Tarsys







• Early Post-Op


TARSYSEyelid Reconstruction

TARSYSEyelid Reconstruction

• Primary Highly Malignant Merkel Cell Tumor




• Wide Tumor Excision with Frozen Section Control & Full-Thickness Reconstruction Using TarSys Spacer Graft







• 4 Week Post-Op • Normal Functioning Right Upper Lid with

Asymptomatic Quiet Anterior Segment• Left Upper Eyelid Ptosis Secondary to Hering’s

Law




• 10 Week Post-Op at Peak of Acute Radiation Soft Tissue Injury




• 10 Weeks s/p TarSys Right Upper Lid Reconstruction with Secondary Electron Radiation Therapy

Health & Medicine

TarSys Slideshow - Dr. Robert A. Weiss