July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Free Tarsoconjunctival Graft Combined with Skin-orbicularis Muscle Advancement Flap: A 1-Stage Technique for Eyelid Reconstruction
Author Affiliations & Notes
  • Xin Song
    Ophthalmology, Shanghai Ninth People's Hospital, Shanghai, China
  • Xianqun Fan
    Ophthalmology, Shanghai Ninth People's Hospital, Shanghai, China
  • Footnotes
    Commercial Relationships   Xin Song, None; Xianqun Fan, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6243. doi:
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      Xin Song, Xianqun Fan; Free Tarsoconjunctival Graft Combined with Skin-orbicularis Muscle Advancement Flap: A 1-Stage Technique for Eyelid Reconstruction. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6243.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To report on a new 1-stage technique for the reconstruction of extensive full-thickness defects of the upper eyelid.

Methods : Twelve cases of full-thickness upper eyelid defects were reconstructed using the new 1-stage procedure. The upper eyelid lesions were removed by Mohs micrographic surgery. Extensive defects were characterized as those with a width of 80% or more of the eyelid after sebaceous gland carcinoma excision. The posterior lamella reconstruction was achieved using a free tarsoconjunctival graft from the contralateral upper lid, and the anterior lamella was covered with a skin-orbicularis muscle advancement flap from the ipsilateral upper eyelid. Each surgery outcome was assessed using a subjective scoring system with 4 subsequent grades (poor, adequate, good, excellent). The mean follow up time was 12 months.

Results : The functional and aesthetic of outcomes were generally satisfactory throughout follow-up. The long-term outcome after surgery was poor in 0 cases, adequate in 2 cases, good in 4 cases, and excellent in 6 cases. No cases of flap ischemia or identifiable necrosis of the tarsoconjunctival graft developed in patients. Complications included epithelial keratopathy, upper eyelid ectropion granuloma and notching.

Conclusions : The technique for upper eyelid reconstruction comprises the use of a free tarsoconjunctival graft, which is covered with a skin-orbicularis muscle advancement flap. This 1-stage reconstruction procedure offers an excellent option for the management of extensive full-thickness upper eyelid defects.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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