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B. Hayek, A.Z. Ahmad; Eyelid Burn Reconstruction, a 5–Year Observational Case Series at a Major Burn Center . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3780.
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© ARVO (1962-2015); The Authors (2016-present)
Grafting of burned eyelids has been studied for hundreds of years.1 Debate continues on the choice of graft and timing for effective repair.2 Burn injuries to the eyelids can cause lid retraction and ectropion leading to exposure keratopathy We review 5–year results of split–thickness (STSG) and full–thickness skin grafts (FTSG) for repair of cicatricial eyelid retraction in the burned eyelid complex at a major burn center.
19 eyelids from 11 patients underwent split–thickness or full–thickness skin grafts for eyelid retraction and/or ectropion. Pre–operatively, all patients demonstrated lagophthalmos and exposure keratopathy. Interval from burn to graft, visual acuity, symptoms, graded keratopathy and lagophthalmos were evaluated. Follow–up ranged from 2 to 48 months. All patients were examined, photographed and operated on by one surgeon (AZA).
Interval from burn to graft was 1 week to 12 months. Visual acuity improved or was stable in all patients. Symptoms and graded keratopathy improved in all patients. Lagophthalmos decreased on average of 2.5mm. 4 eyelids from 3 patients who underwent emergent repair developed post–operative cicatrix requiring regrafting of the involved eyelids. Two patients with full thickness skin grafts required debulking to improve the aesthetic appearance.
Cicatricial eyelid retraction and ectropion are effectively repaired with skin grafting. Skin graft failure may be most common in emergent repair. Failed grafts lead to recurrent eyelid retraction which can require regrafting. Debulking of full thickness skin grafts can improve the aesthetic appearance of the eyelid complex.
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