Von Artha Method.—It sometimes happens that by the extirpation of tumors part of both eyelids has to be removed. To restore such defect the following method may be followed:
Two sickle-shaped flaps are raised from the skin bordering the outer margins of the primary incision, according to Von Artha, and sliding them about so as to reform the canthus of the palpebral fissure ([Figs. 104 and 105]).
Fig. 104. Fig. 105.
Von Artha Method.
This method leaves little if any secondary effect, its immediate success depending upon the preservance of the conjunctiva at the time of extirpation.
As will be seen, the foregoing method only included operations about the lower lid. The majority of these operations are required only for the lower lid; where defects of the upper lid are to be corrected the flaps and incisions mentioned must be made to correspond to the defect, while in the V-Y method the incision must be inverted.
Ectropion of Both Lids
In the case of ectropion of both lids the palpebral tissue may be sutured for a period of several months with certain benefit, if no other operations can be decided upon. Or the method may be combined with any other plastic operation deemed serviceable for its correction. In most defects of the upper lid, however, if they are not too extensive, the loose skin of the lid itself can be utilized by sliding flap methods to cover the defect (Kolle).