The complications of blepharoplasty are infrequent, most often minor and transient, and rarely major and permanent with functional or aesthetic consequences. Treatment is above all preventive with screening of "at risk" patients in whom blepharoplasty would be contra-indicated. Patients must be informed of possible risks through informative booklets stressing the most important points. The complications may affect vision. Partial or complete visual loss due to ischemic optic neuropathy, or rarely to compression of the ocular globe by intraorbital hemorrhage, is the most serious complication. Other visual complications include oculomotor disorders, keratoconjunctivitis sicca, epiphora, and chemosis of lymphatic origin. Eyelid complications are more frequent: ptosis of the upper eyelid or lagophthalmia caused by incorrect resection of the skin, scarring, and eyelid fold anomalies. The most severe aesthetic complication is the malposition of the lower eyelid resulting in retraction, lagophthalmia, ectropion, deformation of the external canthus, or lower eyelid tissue relaxation. These malpositions are often minor, sometimes reversible, but they can be major, with psychological, aesthetic, and functional consequences. Other local complications include enophthalmia and hypo- or hypercorrection. General complications may include pigmentation anomalies or infections extending as far as the orbital fat tissue. Finally, complications observed after the newer procedures of laser surgery include ectropion, burns and residual redness. Complications related to periocular injections of filling material are also mentioned. The discussion of these complications is followed by a comprehensive review of the prevention, diagnosis and management of the complications after blepharoplasty.

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Fifty-three eyelids with severe ptosis were treated by frontalis suspension with temporalis fascia. The surgical indications were limited to cases in which there was absent or minimal levator function. The authors used this as a primary modality in patients with congenital ptosis, blepharophimosis syndrome, Marcus Gunn jaw winking syndrome, severe progressive external ophthalmoplegia, severe blepharospasm and post-traumatic ptosis. Temporalis suspension was performed as a secondary procedure after failure of various other procedures, including levator resection, and suspension with PTFE (Goretex), Mersilene, or fascia lata. Results after an average followup period of six months (two to 14 months) were good in 51 cases ; in two cases release of the suspension and recurrence of ptosis were treated by re-suspension with fascia lata.Temporalis fascia has been used in the correction of ectropion, lagophthalmos in facial nerve palsy and in reconstruction of post-traumatic eyelid defects. It has three major advantages: (1) it is autogenous and hence better tolerated than synthetic materials such as Goretex or Mersilene;(2) it is easily harvested, requiring only one operative field, under local anesthesia; (3) it yields minimal post-operative morbidity (no interference with ambulation, shorter convalescence). The disadvantage of this procedure is the fragility of temporalis fascia as compared to fascia lata, which limits its use to patients over six years old.

BACKGROUND AND PURPOSE:Palpebral AVMs (pAVMs) are rare vascular lesions for which the treatment is challenging. Our aim was to present the technical aspects of the presurgical treatment by interventional neuroradiology of pAVMs and to report the clinical and angiographic results of combined (interventional neuroradiology/surgery) treatment of these malformations.

DON prognosis is highly variable. Our results suggest that a non-inflammatory element, probably vascular could be involved in atypical DONs. An earlier recognition could prompt to rapid surgical treatment for these patients.