ESOPRS – EBO Seminar 2025

"Focus on the eyelid"

EBO are proud to work with ESOPRS to present this 90-minute seminar on the eyelid, with world experts from the European Society of Ophthalmic Plastic and Reconstructive Surgery. From malpositions and management of ptosis to tumours and reconstruction techniques, this is a must-attend event for ophthalmic surgeons and eyelid specialists looking to refine their skills and stay ahead in oculoplastic advancements.

Chair	Speaker	Topic	Duration
Prof Marcin Stopa	Ass. Prof. Ulrich Schaudig, MD, FEBO	Eyelid malpositions (including ectropion, entropion, upper lid and lower lid retraction)	20 min
	Prof Santiago Ortiz-Perez	Diagnosis and management of ptosis	20 min
	Prof Artur Klett	Benign and malignant eyelid tumours	20 min
	Dr Ognjen Zrinscak	Eyelid reconstruction techniques (including central tarsorraphy)	20 min
	Q&A		10 min

After you watch the recording, we would really appreciate your feedback to help us develop more and better educational activities for ophthalmologists across Europe.

EBO-ESOPRS Q & A Answers

Is excision of diamond the same as medial spindle?

Yes. In the English literature, this excision is referred to as a diamond-shaped excision. If combined with an adjacent lid resection, the resulting cut is T-shaped, but at 90° lying on the side. A “T” that lies on the side is “lazy” - hence the name of the Lazy-T procedure.

Ulrich Schaudig – Eyelid Malpositions

Why cutting gray line and leaving open? No risk for scarring?

Good question! Yes, there is a risk of scarring - but the wound can be left open for epithelialisation. It is mandatory to leave the everting sutures long enough until the lid margin has healed, otherwise you will get recurrence due to scarring pulling the lid back to the previous inverted malposition.

Ulrich Schaudig – Eyelid Malpositions

Do you sometimes perform more than one "Keilexzision" to correct involutional entropion or prefer a combined procedure?

Lateral block excision usually only needs to be done once. If there is recurrence, it’s often due to renewed laxity at the canthal tendon, not general lid margin laxity. A combined procedure is more common in ectropion than entropion. For entropion, everting sutures and a lateral canthal sling or block excision work well.

Ulrich Schaudig – Eyelid Malpositions

How long do you usually wait for a revision ptosis surgery after a failed ELA attempt?

If you're sure it will fail, operate early to avoid fibrosis. Otherwise, wait until everything settles—at least 4 months. It also depends on the patient’s function and aesthetic concerns.

Prof Santiago Ortiz-Perez – Diagnosis and Management of Ptosis

What is the limit of levator function at which you avoid operating on the levator?

There’s no fixed rule. The worse the function, the more likely the surgery will fail. Some surgeons use levator surgery even with poor function, others prefer frontalis flap with moderate function. I try levator surgery if LF is 5-6 or more, but always warn of possible failure and reoperation.

Prof Santiago Ortiz-Perez – Diagnosis and Management of Ptosis

Would you consider a Conjunctivomüllerectomy in Horner Syndrome even if partially muscular in origin?

Definitely. It’s a nice option, though I don’t use it much myself since I prefer not to excise a large part of the conjunctiva. Personal preference plays a big role.

Prof Santiago Ortiz-Perez – Diagnosis and Management of Ptosis

Is a 3-year-old child treated with fascia lata or silicone rope?

Silicone is an option for frontalis sling, though it has a higher long-term recurrence rate. I now prefer the frontalis flap in most cases.

Prof Santiago Ortiz-Perez – Diagnosis and Management of Ptosis

What’s your follow-up on suspicious lesions?

Depends on the tumour—follow-up ranges from 1 to 4 months.

Prof Artur Klett – Benign and Malignant Eyelid Tumours

In managing patients with malignant nevi, how proactive are you in requesting dermatology consultation for full body mapping?

I request it in most cases.

Prof Artur Klett – Benign and Malignant Eyelid Tumours

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ESOPRS – EBO Seminar 2025

"Focus on the eyelid"

EBO-ESOPRS Q & A Answers

European Board of Ophthalmology