Abstract
BackgroundTo report “Lamellar Rotation Surgery”,a new technique for repairing large and moderate full-thickness upper eyelid defects.MethodsA two-stage technique is described in which a vertical incision is made in the tarsus of the lower eyelid with elevation of the lateral posterior lamella while sparing the lower eyelid orbicularis and skin to be rotated superiorly to form the reconstructed posterior lamella of the upper eyelid. Additionally, a lateral periosteal flap is used to reconstruct the lateral canthal tendon, and a McGregor procedure is used to reconstruct the anterior lamella of the upper eyelid. The flap is divided during a second-stage surgery at 3 months. Three cases are described to showcase this technique.ResultsGood functional and aesthetic results were achieved for the eyelids.ConclusionsThis new procedure may help to address the challenge of repairing full-thickness defects of the upper eyelid.Trial registrationRegistration number: ChiCTR1800018990, 20 Oct 2018, retrospectively registered.
Highlights
To report “Lamellar Rotation Surgery”,a new technique for repairing large and moderate full-thickness upper eyelid defects
The reconstruction of large upper eyelid full-thickness defects represents a challenge in ocular plastic surgery because of the complicated anatomy and function
Large full-thickness upper eyelid defects are a challenge in ocular plastic surgery
Summary
Surgical technique First-stage surgery (Figs. 1, 2 and 3) We vertically incised the tarsus of the lower eyelid and disconnected the lateral inferior retractor, conjunctiva and lateral canthal tendon while sparing the lower eyelid orbicularis and skin. A 30 × 25 mm hard mass involving the tarsus was observed (Fig. 5a and b). Case 2 A 66-year-old woman presented with a recurrent mass on the right upper eyelid. She underwent local surgical excision twice at other clinics with no pathologic diagnosis. A 10 × 7 mm hard mass involving the eyelid margin and tarsus was observed. Case 3 A 78-year-old woman complained of a severe foreign body sensation after upper eyelid tumour (sebaceous gland carcinoma) excision at another clinic. The patient confirmed that the foreign body sensation had completely vanished after the surgery through telephone follow-up She was unable to return to our clinic because of the long distance required for such travel. The video of the first stage surgery is available in Additional file 2
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