OBJECTIVES: To report on a new one-step technique for the reconstruction of lower eyelid marginal defects.
METHOD: Retrospective case series of 5 patients with lower eyelid basal cell carcinomas abutting the eyelid margin. In all patients, the tumour was radically excised with a 3-mm clear cutaneous margin and a 2-mm tarsoconjunctival margin under frozen section control. Defect size ranged from 12 to 22 mm horizontally and from 8 to 9 mm vertically. For eyelid reconstruction, the 2-mm residual lower lid tarsus was advanced superiorly on a conjunctival pedicle and sutured into the posterior lamella defect. The anterior lamella was reconstructed with orbicularis muscle advancement and a free skin graft from the ipsilateral upper eyelid. The outcome following surgery was assessed using a subjective scoring system with 4 subsequent grades (poor, adequate, good, excellent).
RESULTS: At 1 week postoperatively, adequate viability of the grafts was noted in all patients. One patient developed transient punctate epithelial keratopathy. After a mean follow-up of 10 months (range 1 to 21 months) the outcome was "poor" in 0 patients, "adequate" in 0 cases, "good" in 1 case and "excellent" in 4 cases.
CONCLUSION: 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.
|Number of pages||3|
|Journal||British Journal of Ophthalmology|
|Publication status||Published - Dec 2007|
- Aged, 80 and over
- Carcinoma, Basal Cell/surgery
- Eyelid Neoplasms/surgery
- Follow-Up Studies
- Graft Survival
- Middle Aged
- Oculomotor Muscles/surgery
- Ophthalmologic Surgical Procedures/adverse effects
- Reconstructive Surgical Procedures/adverse effects
- Retrospective Studies
- Skin Transplantation
- Surgical Flaps
- Treatment Outcome