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Michael K. Yoon, Laura T. Phan, Timothy J. McCulley; Modified Cutler-Beard Procedure: Secondary Placement of an Autologous Tarso-conjunctival Graft. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1455.
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Since its initial description in 1955, a handful of modifications of the Cutler-Beard procedure have been proposed. Most have involved the addition of a posterior support such as donor sclera. In this study we describe secondary placement of an autologous tarso-conjunctival graft.
Retrospective case series
The medical records of 3 patients were reviewed. Two (54F, 42M) had undergone a traditional Cutler-Beard procedure without a placement of a posterior spacer, at an outside facility. They presented with posterior lamellar retraction with resulting ocular surface disease. Both underwent placement of a tarso-conjunctival graft roughly one year after their initial surgery. In both cases the eyelid position and contour improved with resolution of the ocular surface disease. A third patient (52M) underwent a traditional Cutler-Beard procedure without initial placement of a posterior spacer. One month following initial surgery, at the same time as "take-down" of the flap, a tarso-conjunctival graft was placed. Post-operatively the patient did well with good eyelid position and function.
Secondary placement of a tarso-conjunctival graft following a traditional Cutler-Beard procedure is a technically simple and effective procedure. It can be performed in conjunction with take-down of the initial flap or at a later date following surgery.
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