Abstract
Purpose :
Many techniques have been described for the repair of lower eyelid cicatricial ectropion and large lower eyelid defects following Mohs surgical repair. A significant obstacle can be the incidence of post-operative cicatricial ectropion when repairing this area. The bi-pedicle Tripier flap or “bucket handle” provides bulk, excellent vascularization, and support from the upper eyelid. We describe our surgical experience to previously described techniques.
Methods :
A retrospective chart review was performed of two surgeon’s charts over a two year period. All patients’ charts that underwent a bucket handle flap were selected. Outcomes measured included underlying pathology, Mohs defect area, and total number of procedures performed on the individual patient. All patients were followed through postoperative month three.
Results :
A total of 11 bucket handle flaps were performed. Five patients had a diagnosis of basal cell carcinoma, three patients had a diagnosis of squamous cell carcinoma, and the remaining three had cicatricial ectropion from previous lower eyelid surgery following Mohs surgery. The average defect area was 12.72 cm2. One patient required a lateral tarsorraphy for neurotorphic keratopathy. Otherwise, no patients developed post op cicatricial ectropion, and no patients required further procedures.
Conclusions :
The bucket handle flap is a useful technique for repair of cicatricial ectropion and large lower eyelid defects following Mohs repair. This technique allows for reconstruction of a challenging area with a low complication rate.
This is a 2021 ARVO Annual Meeting abstract.