June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
10 French silicone Foley catheter as expansion device in lid reconstruction surgery
Author Affiliations & Notes
  • Stephen Dryden
    UTHSC Hamilton Eye Institute, Memphis, Tennessee, United States
  • Salil Kumar Mandal
    orbit & oculoplasty and reconstructive surgery, Medical College of Calcutta, Calcutta, India
  • Sara N. Reggie
    UTHSC Hamilton Eye Institute, Memphis, Tennessee, United States
  • James C. Fleming
    UTHSC Hamilton Eye Institute, Memphis, Tennessee, United States
  • Brian T. Fowler
    UTHSC Hamilton Eye Institute, Memphis, Tennessee, United States
  • Nazibul Mallick
    orbit & oculoplasty and reconstructive surgery, Medical College of Calcutta, Calcutta, India
  • Footnotes
    Commercial Relationships   Stephen Dryden, None; Salil Mandal, None; Sara Reggie, None; James Fleming, None; Brian Fowler, None; Nazibul Mallick, None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4674. doi:
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    • Get Citation

      Stephen Dryden, Salil Kumar Mandal, Sara N. Reggie, James C. Fleming, Brian T. Fowler, Nazibul Mallick; 10 French silicone Foley catheter as expansion device in lid reconstruction surgery. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4674.

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

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Abstract

Purpose : To describe the surgical technique using a silicone Foley catheter as a tissue expander versus conventional tissue expander for repair of defects after removal of eyelid tumors. The utility of a tissue expander creates additional tissue expansion to allow for the repair of large eyelid defects.

Methods : After IRB approval was obtained 12 patients over a period of 18 months were enrolled. 7 patients were female and 5 patients were male. 3 patients had upper eyelid malignancies and 9 patients had lower eyelid malignancies.

Results : Tumors were removed with 4mm wide local excision. A 10-French Foley catheter was inserted in the zygomaticotemporal region and expanded by graded inflation with normal saline to a total volume of 10ml over 6 days. On POD#7, the catheter was deflated and a Tenzel rotational flap was performed to close the defect.
In this study, 9 patients had a 60 -70 % post excision defect of the lower eyelid and 3 patients had a 40-50% post excision defect in the upper lid. At POW#1, central palpebral fissure ranged from 7-10mm and at POW#2 central palpebral fissure ranged from 14 -16 mm. Blink reflex was preserved without cases of wound dehiscence.

Conclusions : Our case series highlights the successful use of a novel surgical approach for eyelid expansion utilizing a 10-French Foley catheter. This approach allows for tissue expansion temporally, permitting the closure of large eyelid defects typically not possible with a Tenzel flap and provides for excellent functional outcomes without closing a patient’s eyelids limiting vision for weeks to months as is typical of other reconstructive modalities (eg. Cutler Beard Flap, etc). 10-French Foley catheters are both cost effective and readily available in most hospital settings. The authors believe this makes it an excellent tissue expander in the under-developed world where access to other more expensive options are limited. Further, the successful results of this novel utility make it a reasonable more cost effective option in the United States and other developed countries.

This is a 2020 ARVO Annual Meeting abstract.

 

External photo showing 10-French Foley catheter inflated to 10ml at the flap harvest site at six days post-op

External photo showing 10-French Foley catheter inflated to 10ml at the flap harvest site at six days post-op

 

External photo showing the same patient two weeks post left lower lid Tenzel rotational flap reconstruction. The patient still has mild edema appropriate for post-op week two. Note the symmetry of the palpebral fissures and lateral canthi position between both eyes.

External photo showing the same patient two weeks post left lower lid Tenzel rotational flap reconstruction. The patient still has mild edema appropriate for post-op week two. Note the symmetry of the palpebral fissures and lateral canthi position between both eyes.

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