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, MD, FACS

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.

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

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

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

• 10 mm x 40 mm

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

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

• Note Left Lagophthalmos Secondary to LLL Retraction

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

• Standard Subciliary Approach

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

• Skin-Orbicularis Muscle Flap

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

• Inferior Boarder of Tarsus Delineated

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

• Elevate Septum - Lower Lid Retractors

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

• Removal of Previously Placed Spacer

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

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

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

• TarSys Attached to Medial Deep Tissues - Medial Canthal Tendon

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

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

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

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

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

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

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

• Note Symmetry of Lower Lid Position Relative to Inferior Limbus

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

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

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

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

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid 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

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

• 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

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

• Lagophthalomos Associated with Lower Eyelid RetractionMaxillary Hypoplasia and Prior Blepharoplasty

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

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

• Primary Highly Malignant Merkel Cell Tumor

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

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

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

Whitnall’s Ligament

Superior/Forniceal Conjunctiva

Lacrimal GlandCut Edge of Levator Just Above Aponeurosis Junction

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

Conunctiva Deep To Tarsys - Anchored on Anterior Surface of Graft

Levator Muscle Anchored to Superior Edge of Tarsys

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

• Early Post-Op

Robert A. Weiss, MD, FACS

TARSYSEyelid Reconstruction

TARSYSEyelid Reconstruction

• Primary Highly Malignant Merkel Cell Tumor

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

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

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

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

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

Law

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

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

Robert A. Weiss, MD, FACS

TarSysEyelid Reconstruction

TarSysEyelid Reconstruction

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