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.