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Year : 1988  |  Volume : 36  |  Issue : 3  |  Page : 109

Ophthalmic plastic surgery


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T P Ittyerah

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How to cite this article:
Ittyerah T P. Ophthalmic plastic surgery. Indian J Ophthalmol 1988;36:109

How to cite this URL:
Ittyerah T P. Ophthalmic plastic surgery. Indian J Ophthalmol [serial online] 1988 [cited 2023 Apr 1];36:109. Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?1988/36/3/109/26479

Ophthalmic plastic surgery not only deals with the appearance and beauty of the eye but also with the function of the eye and preservation of vision. This important sub-speciality was formed as a part of ophthalmology perhaps because of its importance in preservation of eye sight indirectly. Eventhough there were reports of ophthalmic plastic surgery being per­formed by eye surgeons right from the formative centuries of modern medicine and surgery, it was only recently that this sub-speciality was accepted as a part of ophthalmology. Like any other sub speciality in surgery, there is overlapping of territory between the neighbouring specialities like Otorhinolaryngology, Dermatology, plastic surgery and orthopaedic surgery.

Rapid progress was possible in ophthalmic plastic surgery because of several factors viz. the vast experi­ence and modifications done by previous surgeons, the progress in other fields of science viz. General Surgery, Pathology, Physiology, Microbiology, Physics, Chemistry, Electronics, Radiology, Pharmacology and Clinical Medicine. The judicious application of the knowledge acquired in these fields with common sense helped us to achieve perfection in ophthalmic plastic surgery. Even though there are several great surgeons who have contributed new information regarding dif­ferent aspects iri ophthalmic plastic surgery in a casual way, the first exclusive ophthalmic plastic surgical clinic was started by Dr. Wendell Hughes and Byron C. Smith in 1941 in New York. Their concentrated effort in one particular type of work gave a new thrust to the progress in ophthalmic plastic surgery.

Besides new ideas in planning surgery, new instruments also contributed in perfecting techniques and improving results. Ramon Castroviejo of Spain was perhaps the single ophthalmic surgeon who put forward new designs and developed a large number of useful ophthalmic plastic surgical instruments and equipment. Mucotome (Electrokeratome and -Dermatome became important aids for the present day ophthalmic plastic surgeons.

Progressive changes in the suture materials and need­les made surgical procedures a pleasure even to the least inclined ophthalmologist. The revolution in sutures and suture material started with the formation of the first Suture Panel for Ophthalmology formed during the meeting of American Academy of Ophthalmology and Otorhinolaryngology with the co-operation of Johnson & Johnson.

The major work in ophthalmic plastic surgery even today is for improving appearance. There was no doubt that Indians appreciated beauty of the eye even from the vedic periods and perhaps,'Susrutha' was the first plastic surgeon known to the world to perform the reconstruction of the nose. Later, when the socio-economic condition of our country was drastically changed and the vast majority had to live under the poverty line, we could not afford sophisticated ophthal­mic plastic surgery for improving appearance. But with the changing pattern in society and with improve­ments in the economy, we have to fulfil the aesthetics needs also of our countrymen. With life expectancy increasing we are bound to have a lot of `old age' problems in the eyelids and surrounding tissues. Be­sides this rapid industrialisation has lead to different types of ocular trauma and given the oculoplastic surgeon several challenging opportunities.

It is the time for eye surgeons to rise to the demands of society and develop skills in ophthalmic plastic surgery. The All India Ophthalmological Society can lead the way by providing the 'necessary working knowledge in this important sub-speciality by organiz­ing and sponsoring training programmes in ophthalmic plastic surgery. Through this journal we can share our views and experience in this subject.

It is indeed gratifying that few institutions in North India have already started training programmes. I am sure, soon this will spread to the southern part of our country. The practice of leaving lid surgery and lacrimal sac surgery to the junior doctors may lead to cosmetically and functionally unacceptable re­sults. It is time to develop this branch as an important sub-speciality in ophthalmology in all major institutions in India.


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