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How to remove an eyelid mass and repair the eyelid margin | VETgirl Veterinary Continuing Education Videos

In this VETgirl online veterinary continuing education video, we demonstrate how to properly close the eyelid margin following resection of an eyelid mass. The cut edges are grasped with small toothed forceps (such as Bishop-Harmons) to allow visualization of the subconjunctival tissue. Small, absorbable suture (e.g., such as 5-0 Vicryl) is used for the entire closure. A few subconjunctival simple interrupted sutures are placed to bring the cut edges into apposition. It is crucial to ensure these sutures remain superficial to the conjunctival surface to prevent corneal trauma from suture tags. A “Figure-of-8” suture pattern is the closure style of choice for eyelid margins as it allows the eyelid margins to be perfectly apposed but places the knot away from the cornea.

The Figure-of-8 is performed in the following way: Grasping one of the cut margins, the needle is passed through the haired skin and exits the cut surface of the eyelid, approximately 2 mm from the edge of the margin. The opposite cut margin is then grasped and the needle is passed into the cut surface and exits a meibomian gland opening approximately 2 mm from the cut edge. Moving again to the opposite cut margin, the needle is passed through a meibomian gland opening and exits the cut surface, very close to the initial suture. Finally, the opposite cut surface is grasped and the needle is passed through the cut surface and exits the haired skin. As the knot is pulled securely, the eyelid margins should align properly and the knot should be tied to lay against the haired skin. These suture tags are left long, to allow them to be incorporated into the rest of the closure. The skin wound is then closed with simple interrupted sutures – after the initial 2 throws of each knot, the tags from the previous sutures are laid into the knot, allowing all of the tags to be directed away from the cornea.

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  1. Beautiful easy to follow video. Do you biopsy or FNA aspirate the mass to get a pathologic diagnosis before you perform the surgery?

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