Reconstruction of small to large lower lid marginal defects with local tarsoconjunctival flap advancement combined with orbicularis muscle advancement and free skin graft is associated with a good functional and cosmetic outcome and limited donor-site morbidity.

The results of this series suggest that nitrous oxide probe cryotherapy for primary periocular basal cell carcinomas up to 8 mm diameter has a recurrence rate of ∼8%. Cryotherapy has certain advantages over surgical removal of tumours of this size in the periocular region, but careful follow-up is advisable.

A 51-year-old white woman had an 18-month history of unilateral chronic bulbar chemosis after 4-eyelid cosmetic blepharoplasty. Tetracycline 2% was injected subconjunctivally in the area of the chemosis. After 2 injections over a period of 6 months, the chemosis resolved completely. At final follow-up 9 years later, the patient remained free of chemosis. Two other patients with unilateral chronic chemosis of unknown cause were similarly treated with tetracycline 2% subconjunctival injections. In the first patient, chemosis had been present before an upper eyelid blepharoplasty. After one injection with tetracycline 2%, the chemosis resolved completely and remained absent at final follow-up 8 years later. The second patient reported a 10-year history of chronic chemosis. He had never had blepharoplasty. Two injections with tetracycline 2% within an interval of 6 months were given. At final follow-up 4 years later, mild residual chemosis was present.

Corneal dellen represent a potential cause of postoperative pain following transconjunctival orbital decompression.