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Eric S. Ahn, Julian D. Perry, Milap Mehta, Craig D. Lewis; Repair of Moderate and Large Full Thickness Eyelid Defects With Internal Cantholysis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1444.
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To determine the safety and efficacy of internal cantholysis for repair of large full-thickness eyelid defects.
A retrospective review of consecutive case series between November 2007 and November 2010 of all patients undergoing transconjunctival lateral cantholysis for repair of moderate and large full thickness eyelid defects was performed. Defects greater than or equal to 14mm in horizontal length were considered moderate, while those greater than or equal to 20mm in horizontal length were considered large. Data collected included patient demographics, indication for surgery, defect size, type and location, other concomitant repair, follow-up interval, and complications.
A total of twenty-two patients (22 eyelids) underwent internal cantholysis for repair of moderate or large full thickness eyelid defects. There were 12 male and 10 female patients with an average age of 72 years (range, 45-94 years). Average defect size was 18.5 mm (range, 14-25 mm) while the average follow-up interval was 5.2 months (range, 1-20 months). Wound dehiscence did not occur in any of the repairs. Complications were as follows: persistent canthal dystopia (3 cases), eyelid margin notch (3 cases), pyogenic granuloma (2 cases), trichiasis (2 cases), eyelid margin nodule (1 case), lower eyelid elevation of 1-mm (1 case), and mild resolving medial lagophthalmos (1 case). No patient requested or required further surgery on the operated eyelid for any reason during the study period.
Internal cantholysis can effectively aid repair of moderate and large full-thickness eyelid defects. Although complications of this technique appear to be higher than similar repair of smaller defects, morbidity is reduced compared to other therapeutic options, such as a semicircular flap or shared tarsoconjunctival flap procedure.
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