Sliding tarso-conjunctival flap combined with allogeneic sclera transplantation for one-stage posterior eyelid defect
10.3760/cma.j.cn114453-20191204-00366
- VernacularTitle:滑行睑板结膜瓣联合异体巩膜移植一期重建眼睑后层缺损的临床效果
- Author:
Junping LI
1
;
Dongping LI
;
Na ZHOU
;
Yanzhu LUO
;
Yuhong WANG
Author Information
1. 汉口爱尔眼科医院，武汉 430021
- Keywords:
Tarso-conjunctival flap;
Allogeneic sclera;
Eyelid defect;
Tumor, eyelid
- From:
Chinese Journal of Plastic Surgery
2021;37(12):1364-1369
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were collected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1-2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm). The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts. The postoperative follow-up was performed to observe the morphology of the eyelid margin, the repair of the eyelid defect area, the degree of movement of the eyelid and the function of opening and closing, and lifting.Results:A total of 8 cases were included, 3 males and 5 females, aged 31-76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Aside from the absence of eyelashes in the reconstructed area, the eyelids were in good shape. The movement of eyelid was good, the functions of opening and closing and lifting were normal. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.
