Eyelid Repair Research Articles

Clinical Treatment Efficacy and Incidence of Complications in Asymmetric Double Eyelid Repair Surgery

Objective: It’s to analyze the clinical treatment efficacy and incidence of complications in asymmetric double eyelid repair surgery. Methods: Fifty patients who underwent asymmetric double eyelid repair surgery at our hospital from March 2022 to March 2023 were selected. Using a random number table, the patients were divided into two groups of equal size. The observation group (n=25) underwent small incision fat removal and continuous buried suture repair, while the control group (n=25) underwent traditional incision surgery. The treatment efficacy (excellent, effective, ineffective) and one-year postoperative complication incidence (conjunctival blockage, eye swelling, bruising) were compared between the two groups, as well as clinical data (operation time, healing time, incision length). Results: The total effective rate in the observation group (96%) was higher than that in the control group (64%); the one-year postoperative complication incidence in the observation group was lower than that in the control group (P<0.05); the operation time, healing time, and incision length in the observation group were all less than those in the control group (P<0.05). Conclusion: Double eyelid repair surgery demonstrates significant clinical efficacy and a low incidence of complications in treating asymmetric double eyelids, warranting further promotion.

Characteristics of Patients with Eyelid Laceration in Kariadi General Hospital Semarang

Abstract
 Introduction & Objectives : Eyelid laceration is one of the most common ocular injuries with complications. This study examines patient characteristics with eyelid lacerations at Kariadi General Hospital Semarang.
 Methods : An observational study used medical records data from April 2019 to January 2023. Age, gender, eyelids, grading, area of laceration, mechanism of trauma and injury, canthal and canalicular involvement, associated injury, and surgery were recorded.
 Results : From 75 patients, lacerations were more common in men (56, 75%) and ages 16-<50 years (43, 57%). Lacerations occurred in right lower (21, 28%), right upper (17, 23%), right upper and lower (16, 21%), left lower (9, 12%), left upper (8, 11%), and left upper and lower (4, 5%) eyelids. They were mainly medial (52, 69%), lateral (12, 16%), and central (7, 9%). Full-thickness lacerations (58, 77%) outnumbered lamellar thickness (17, 23%). Blunt trauma (63, 84%) was the main mechanism, with motor vehicle accidents leading 30 (40%). Canthal involvement was absent in 41 cases (55%), medial in 29 (39%), and lateral in 5 (7%). Canalicular involvement was absent in 39 cases (52%) and present in 36 (48%). The three most frequent of associated injury of the patients was 16 (21%) subconjunctival bleeding, 12 (16%) orbital hematom, 9 (12%) conjunctival laceration. All patients underwent surgery, with eyelid repair most common (32, 43%).
 Conclusion : Eyelid lacerations mainly involved right lower eyelid, medial region, and are full-thickness. Blunt trauma, particularly motor vehicle accidents, was the main cause. Most cases lack canthal or canalicular involvement. Eyelid repair was the most frequent choice of surgery.

Characteristics of Patients with Eyelid Laceration in Kariadi General Hospital Semarang

Introduction and Objective: Eyelid laceration is one of the most common ocular injuries with complications. This study examines patient characteristics with eyelid lacerations at Kariadi General Hospital Semarang. Methods: An observational study used medical records data from April 2019 to January 2023. Age, gender, eyelids, grading, area of laceration, mechanism of trauma and injury, canthal and canalicular involvement, associated injury, and surgery were recorded. Results: From 75 patients, lacerations were more common in men (56, 75%) and ages 16-<50 years (43, 57%). Lacerations occurred in right lower (21, 28%), right upper (17, 23%), right upper and lower (16, 21%), left lower (9, 12%), left upper (8, 11%), and left upper and lower (4, 5%) eyelids. They were mainly medial (52, 69%), lateral (12, 16%), and central (7, 9%). Full-thickness lacerations (58, 77%) outnumbered lamellar thickness (17, 23%). Blunt trauma (63, 84%) was the main mechanism, with motor vehicle accidents leading 30 (40%). Canthal involvement was absent in 41 cases (55%), medial in 29 (39%), and lateral in 5 (7%). Canalicular involvement was absent in 39 cases (52%) and present in 36 (48%). The three most frequent of associated injury of the patients was 16 (21%) subconjunctival bleeding, 12 (16%) orbital hematom, 9 (12%) conjunctival laceration. All patients underwent surgery, with eyelid repair most common (32, 43%). Conclusion: Eyelid lacerations mainly involved right lower eyelid, medial region, and are full-thickness. Blunt trauma, particularly motor vehicle accidents, was the main cause. Most cases lack canthal or canalicular involvement. Eyelid repair was the most frequent choice of surgery.

Lower Eyelid Laceration in Children: A Case Report

Introduction : Eyelid lacerations may be associated with serious ocular injury and are often accompanied by other ocular injuries. Most injuries occur in children. Eyelids have an important role in protecting the globe. Effective management of eyelid lacerations requires an understanding of the basic anatomical features of the eyelids.
 Case Illustration : A two-year-old boy was brought to our emergency department after getting scratched in the eyelid by the family dog. The patient has received first aid and a tetanus shot at another hospital. Eye examination shows a lower eyelid laceration on the right eye, extending from the medial downwards around 3 cm. Visual examination was central+, steady+, maintenance+, and eye movement was within normal limits. The patient was admitted to undergo eyelid repair in the operating room.
 Discussion : The first step in eyelid repair is wound irrigation and removal of foreign particles to avoid infection and inflammation, and primary repair of eyelids should be performed within 12 to 24 hours of the injury to reduce subsequent complications. The recommended method for best wound closure and healing is gently handling tissue edges, slight eversion, and using the smallest diameter sutures. A proper pre-operative assessment and surgical planning include evaluation of the thickness of the defect, the size, the location, and the involvement of canthus and lacrimal drainage. The goals are to provide adequate eye closure, preservation of tear film, maintenance of visual field, and aesthetics.
 Conclusion : A thorough knowledge of the eyelid anatomy and suture technique is important to successfully repair the defect while maintaining eyelid function.

Outcome Evaluation of Eyelid Laceration Surgery in Kariadi General Hospital Semarang

Abstract
 Introduction & Objectives : Eyelid laceration are common in cases of trauma involving the eye. This study will discuss cases of eyelid lacerations, procedures, and the follow-up of patients who underwent surgery at Kariadi General Hospital Semarang.
 Methods : This study used an observational analytic design and was conducted retrospectively. All patients who underwent eyelid surgery April 2019 to January 2023. Age, gender, laceration location, mechanism of trauma, canalicular involvement, and surgery were recorded, subjective complaints and patient complications after surgery.
 Results : Of the 76 patients (94 eyelid lacerations) included in the study, men exhibited a greater vulnerability (56,75%) and mostly aged around 16-<50 years (43, 57%). In terms of the laceration location, it occurred in right lower (39,36%), right upper (35,10%), left lower (13,82%), and left upper (11,70%) eyelids. Blunt trauma (83,78%) was the main mechanism, with motor vehicle accidents leading (40,54%). Canalicular involvement was present in 35 cases (47,29%). All patients underwent surgery, with eyelid repair to all of the patient following by recanalization (39,18%). The most common complaint of patients after surgery in the first week of control was pain (47,29%) followed by a feeling of lump (13,51%). A total of 25 patients (33,78%) stated that they had no complaints.
 Conclusion : Eyelid lacerations mainly involve young adult people, right lower eyelid. Blunt trauma, particularly motor vehicle accidents, is the main cause. Most of the patients had no complaints in the1 week postoperative control, and they increased in subsequent controls.

Severe Upper Lid Fornix Prolapse After a Ptosis Repair in Floppy Eyelid Syndrome: A Case Report.

Patients with profound floppy eyelid syndrome (FES) may experience challenges achieving eyelid and tarsal stability in the setting of severe ptosis. A 43-year-old woman with sleep apnea presented to clinic with difficulties driving because of droopy eyelids. She also experienced chronic tearing, crusting, and discharge of the eyes. She was diagnosed with severe FES and significant ptosis. She underwent a wedge excision of the upper lid in the medial and lateral aspect of the upper lid. This was followed by a ptosis repair that resulted in complete upper lid fornix obliteration causing the conjunctiva to obstruct the patient's pupils. The patient's symptoms ultimately improved after a definitive fornix reconstruction. Her visual field symptoms were improved with 1-year follow-up. To our knowledge, this is the first report in the literature of a prolapsed fornix resulting in vision obstruction after floppy eyelid repair via a wedge excision followed by a ptosis repair via an external levator advancement. Given these unusual findings for the patient's age, further investigations into treatment management may be necessary to mitigate eyelid reconstruction complications in younger patients with FES.

Considerations in Eyelid Reconstruction in Treacher Collins Syndrome: A Scoping Review

Objective: Treacher Collins syndrome (TCS) is a rare congenital craniofacial disorder with extensive associated eyelid deformities. Given its rarity and the breadth of manifestations, many treatment options have been previously described, but never summarized. Design: A literature review adherent to PRISMA guidelines and pertaining to surgical outcomes of TCS eyelid repair was performed. Successful surgical outcomes were defined as improvement or satisfaction as described by the authors. Results: A total of 144 patients and 212 procedures from 24 articles were included in this review. The mean age of first eyelid reconstruction was 13 years (range 1-36 years). Previous craniofacial surgery for malar insufficiency was performed in 57% of patients using a calvarial bone graft (n = 56), temporal osteomuscular flap (n = 21), split-rib graft (n = 3), and malar implant (n = 2). Patients underwent between 1 and 3 eyelid procedures (median 2). Most common eyelid defects included pseudocolobomas (54%), lateral canthal dystopia (38%), and true colobomas (8%). Coloboma repairs had the highest success rate (92%), followed by pseudocoloboma (80%), and lateral canthal dystopia repair (79%). Coloboma repair had the highest revision rate (13%), followed by pseudocoloboma repair (2%). Conclusion: TCS eyelid abnormalities most commonly present as pseudocolobomas, true colobomas, and lateral canthal dystopia. Given this diversity of presentations in TCS, surgical management must ultimately be tailored to the collective defects present with consideration of previous craniofacial reconstruction and current midface development.

Does cataract surgery in patients with concurrent lower lid malposition increase the risk of postoperative endophthalmitis?

ObjectiveTo evaluate the safety of performing cataract surgery prior to eyelid (entropion/ectropion) surgery in patients with concurrent cataract and lower eyelid malposition. DesignRetrospective case series. Participants and MethodsPatients with concurrent lower eyelid malposition and cataract undergoing cataract surgery before lower eyelid repair from 2013 to 2020 were identified from two ophthalmologists (M.L.W., G.R.). Both surgeries were performed by the same ophthalmologist, with eyelid repair completed at least 1 month following cataract extraction. Data analysis was performed with two-parameter estimations. The primary outcome was the postoperative endophthalmitis rate in this cohort. Results129 cases in 90 patients were found (86 involutional entropion and 43 involutional ectropion). No cases of endophthalmitis were encountered. Statistical analysis using the 95% Jeffreys interval for one-sample binomial proportion revealed an upper limit of 1.9%. The Agresti-Caffo interval of the proportional difference between the study procedure and historical incidence data of postoperative endophthalmitis following cataract surgery alone yielded an estimate of 0.8% with an upper confidence limit of 2.2%. ConclusionWe present preliminary evidence on the endophthalmitis risk in patients with concurrent lower eyelid malposition and cataract who undergo cataract surgery prior to eyelid repair. We propose that this strategy may be a viable option to expedite vision restoration and reduce the risk of recurrent lower eyelid malposition in select patients. More data are required to reach statistically significant noninferiority and show that a malpositioned lower eyelid is not a risk factor for postoperative endophthalmitis following cataract surgery.

Mitigation of traumatic blepharoptosis with "central levator tuck": A novel approach in upper eyelid repair.

Complex upper eyelid lacerations can present to the emergency department after a myriad of trauma. The goal of the surgical repair is anatomical and functional recovery along with symmetrical cosmesis. Despite meticulous surgery, post traumatic blepharoptosis may develop. We describe an additional step during upper eyelid laceration repair to help mitigate the development of traumatic blepharoptosis. Patients with traumatic eyelid laceration without head injury, globe injury or associated orbital fractures, who were planned for a primary upper eyelid repair were included. Intraoperatively, wound margins and tissues were identified to establish anatomical continuity. After the LPS muscle was reinserted onto the tarsus, a single, central suture LPS plication - the "central levator tuck" was performed. This helped in improving the muscle action as well as strengthening its reattachment onto tarsus. Four cases underwent laceration repair with this modified technique. The nature of eyelid injury, surgical technique, and the outcome at 6 months is described. Three patients had a successful outcome, whereas one patient developed early scarring which reduced with scar therapy over time. We describe a simple and effective "central levator tuck" technique for traumatic eyelid laceration repair with optimal functional and cosmetic outcome while reducing the development of blepharoptosis in four patients.

Canalicular laceration repair using a self-retaining, bicanalicular, hydrophilic nasolacrimal stent

ABSTRACT Purpose: To evaluate outcomes of primary eyelid and canalicular laceration repair using a self-retaining bicanalicular hydrophilic nasolacrimal stent. Methods: This study is a retrospective review of seven patients with canalicular laceration primarily repaired with a self-retaining bicanalicular nasolacrimal stent within 72 hours of initial injury. After lacrimal intubation, repair was performed by reapproximation of the lacerated tissues. Data collection included ophthalmic examination, mechanism of injury, involvement of upper/lower/common canaliculi, symptoms of epiphora, operative time, stent extrusion and canalicular irrigation. Results: Seven patients with monocanalicular laceration were repaired using the self-retaining bicanalicular nasolacrimal stent. The stent was left in place an average of 5 months. The average operative time was 29.3 minutes. None of the stents extruded prior to removal. After 5 months, the stent was removed successfully without difficulty. All patients reported subjective improvement in epiphora, with complete resolution of symptoms. Anatomic success was confirmed with irrigation in all cases. There were no complications associated with usage of the self-retaining bicanalicular nasolacrimal stent. Conclusions: Primary repair of canalicular lacerations can be successfully performed with a self-retaining bicanalicular nasolacrimal stent. This stent has several advantages, including potentially faster operative times, no need for intranasal fixation or retrieval, easier intubation in the lacrimal system, and improved anatomic reapproximation of lacerated tissues.

Long-Term Results of the Surgical Management of the Upper Eyelids in "Ablepharon"-Macrostomia Syndrome.

To describe the late results of the placement of skin graft over conjunctiva-Müller muscle complex in 3 patients with ablepharon-macrostomia syndrome (AMS) and to review the procedures used to manage the upper eyelids in AMS. The authors searched the Pubmed database for all articles that used the term "ablepharon-macrostomia syndrome" in any field. Data collection included description of eyelid changes, age at surgery, status of the cornea before surgery, type of eyelid repair, and final outcome. Two previously reported siblings were reevaluated 10 and 15 years after a single reconstructive operation. A new case from Peru is also described. Only 15 patients with AMS have been described in 12 articles. In 60% of the cases, the lids were described as absent. The surgical modalities employed to reconstruct the upper eyelids were quite variable, including local flaps, lid sharing procedures, and even a masquerade flap. At long-term follow-up, all 3 cases who underwent upper eyelid lengthening with full thickness skin grafts placed over Müller muscle had clear corneas with a small amount of lagophthalmos. The lids in AMS are not absent and should not be managed with complex reconstructive techniques. Full thickness skin grafts placed over the inner aspect of the palpebral conjunctiva allow permanent eye protection.The upper eyelids in ablepharon-macrostomia syndrome can be permanently lengthened with full thickness skin grafts over Müller muscle.

Eyelid Malposition Repair: A Review of the Literature and Current Techniques.

Eyelid malposition is a challenging problem faced by surgeons. Given the delicate nature of the eyelid and its complex anatomy, eyelid repair requires both a comprehensive understanding of eyelid anatomy along with thorough presurgical planning and surgical execution. A wide range of options is available for eyelid reconstruction but the location and extent of the deformity often dictate the type of repair. This article is a review of commonly encountered forms of eyelid malposition. Relevant reconstructive techniques and current evidence-based methods of reconstruction are discussed in detail. Anatomical considerations, the nature of specific defects, pearls of preoperative evaluation, and the reconstructive options available to the facial plastic and oculoplastic surgeon are outlined. Topics discussed include ectropion, entropion, eyelid retraction, and blepharoptosis.

Repair Techniques for Failed Double-Eyelids Involving Restoration of Eyelid Anatomical Structure and Function.

This study aimed to evaluate techniques for repairing previously failed double-eyelid surgeries based on different anatomical structure injuries. A total of 120 patients with failed double-eyelids in our hospital were enrolled and classified into four types according to their anatomical structure damage: type I, unsmooth radians of the double-eyelid line; type II, upper socket depression; type III, iatrogenic ptosis; and type IV, comprehensive damage. Accordingly, methods of restoration included orbital septum fat supplement, repair of levator palpebrae superioris, and treatment of scar. Postoperative follow-up time points were 1week, 1month, and 6months. Outcome observations were binocular symmetry, fluency of double-eyelid, scar recovery, height and contour profile of the upper eyelid margin, and plumpness of the upper eyelid. The eyelid morphological score was evaluated using photographs of preoperative and 6-month postoperative data, and the effect of eyelid repair was evaluated objectively by statistical analysis. At 1month after surgery, the height of the upper palpebral margin was maintained in most patients and located at 1-2mm below the superior limbus. At 6months after surgery, most patients had better restorative effects. Comparison of mean eyelid morphological scores showed a statistically significant improvement following surgery (P < 0.001). The technique of restoring eyelid anatomical structure in failed double-eyelids not only recovered the normal function of injured eyelids but also produced satisfactory aesthetic effects. This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Kissing sebaceous carcinoma of the eyelids: a rare case report

Sebaceous gland carcinomas are tumours of the skin adnexa which occur around the periocular region of elderly females. It is a rare malignancy usually involving the upper eyelid and has an indolent course. Treatment is surgical excision of the lesion with lid reconstruction. Here authors discuss a case of swellings involving both the eyelids of an elderly female diagnosed as sebaceous gland carcinoma on biopsy for which wide local excision and primary eyelid repair was done. This case has been presented as the lesion masquerades as a benign one but is malignant with multifocal spread.

Algorithms for eyelid repair

Algorithms for eyelid repair

Eyelid sebaceous gland carcinoma: Varied presentations and reconstruction outcome.

PURPOSE:To analyze varying clinical presentations, histopathological features, and management outcome of sebaceous gland carcinoma (SGC) of the eyelid.MATERIALS AND METHODS:We retrospectively reviewed medical records of 30 patients with histologically proven cases of SGC of eyelid treated at tertiary care hospital.RESULTS:Patients were in the age group of 28–80 years, among which 18 (60%) were females and 12 (40%) were males. Mean follow-up period was 29.83 ± 8.14 months. Six out of 30 cases were lost to follow-up; hence, only 24 cases were analyzed for reconstruction techniques and management outcome. Initial anatomic sites involved were upper eyelid (10 cases [33.33%]), lower eyelid (5 cases [16.66%]), both upper and lower eyelid (10 cases [33.33%]), and medial canthus (1 case [3.33%]). Orbital extension at presentation was present in 4 cases (13.33%) while metastasis to preauricular lymph nodes was seen in 1 case (3.33%). T2 was the most common category according to TNM staging (14, 58.33%). Reconstruction techniques included direct closure with or without cantholysis in 5 (20.83%), closure with Tenzel's semicircular flap in 2 (8.33%), Cutler Beard repair in 5 (20.83%), and Hughes's flap with either cheek advancement flap or full-thickness skin graft in 3 (12.5%). Both upper eyelid and lower eyelid repair were done in three (12.5%) cases and medial canthal repair in one (4.16%) case. Five (20.83%) cases underwent exenteration. On histopathological examination, 23 (95.83%) patients had localized tumors while only 1 (4.16%) patient had pagetoid invasion. Recurrence was observed in three (12.5%) cases. One (4.16%) case died subsequent to brain metastasis.CONCLUSION:SGC of eyelid may have varied presentations, but early diagnosis and consequent surgical therapy has good outcome and higher survival rate.

Comparison of Simulation-Based versus Live Tissue–Based Ocular Trauma Training on Novice Ophthalmologists: Repair of Marginal Eyelid Laceration Model

Introduction Simulation training in medical education provides the ability to teach valuable surgical skills in an environment free of risk to patients. Surgical simulation in ophthalmology continues to evolve as new technologies advance, though widespread use in ophthalmology outside of cataract surgery simulation is lacking. Here, we present a study into the efficacy of surgical simulation for eyelid laceration repair when compared with standard tissue-based instruction. Materials and Methods The study included 43 ophthalmology residents and 16 staff ophthalmologists from the Ocular Trauma Surgery Laboratory (OTSL) at the Uniformed Services University of the Health Sciences (USUHS). After initial evaluation on their ability to repair marginal eyelid lacerations on a porcine eye, residents were randomized to receive training in marginal eyelid repair technique from faculty preceptors using either traditional porcine tissue or the Ocular and Craniofacial Trauma Treatment Training System (Medical Device and Simulation Laboratory). They were then reevaluated after training. Participating staff also underwent initial evaluation, self-guided training, and post-training evaluation. Outcome measures included successful repair of laceration, number of sutures required to close a 10-mm wound, time required to repair, and the following graded on a scale of 1–4 (1—poor, 2—fair, 3—good, 4—excellent): tarsal plate reconstruction and margin approximation. Results Among residents, improved scores in marginal approximation were noted after training when comparing scores both within the simulator-trained group (pre-training score: 2.0, post-training score: 3.0; p = 0.03) and between the simulator (SIM) and live tissue (LIVE) groups (SIM: 3.0, LIVE: 2.0 p = 0.03). Neither residents nor staff demonstrated significant differences between SIM versus LIVE in other metrics evaluated. Response in a post-study survey was favorable to simulator training, with 79% noting the simulator was helpful in teaching skills, and 83% noting they would use the simulator again. Conclusion Simulator technology for teaching marginal eyelid laceration repair appears to be noninferior to traditional tissue-based instruction. Additionally, it appears to be superior when evaluating the ability to approximate the eyelid margin appropriately. Simulators are safe and ethical alternatives to tissue-based instruction, and are favorably received among trainees, and therefore warrant additional investigation and development for ophthalmic surgical training.

Free tarsomarginal graft for large congenital coloboma repair in patients with Tessier number 10 clefts

The aim of this study was to evaluate the long-term outcome when a free tarsomarginal graft is used to repair a large congenital coloboma in patients with a Tessier number 10 cleft. This was a retrospective, interventional case series. The medical records were reviewed for five children (six eyes) diagnosed as having Tessier number 10 cleft with large upper eyelid defects and symblepharon. These children were referred to the Department of Ophthalmology of Shanghai Ninth People's Hospital, between May 2007 and December 2012. Reconstructive techniques included repair of the upper eyelid defect with a free tarsomarginal graft taken from the lower eyelid, and reconstruction of the conjunctival fornix by using a conjunctival autograft after symblepharon lysis. All the children were followed up for more than 2 years. Postoperative upper eyelid contour, viability and function for corneal protection, and recurrence of symblepharon were assessed. A one-stage reconstruction procedure was used in all children. All reconstructed eyelids achieved a surgical goal of providing corneal protection and improved cosmesis, with marked improvement of exposure keratopathy and no associated lagophthalmos. Adequate reconstruction of the upper fornix was obtained, and there was no obvious recurrence of symblepharon. A free tarsomarginal graft is beneficial and seems to be an adequate method for reconstruction of large eyelid defects in children with a Tessier number 10 cleft. Symblepharon lysis with a conjunctival autograft for reconstruction of the ocular surface can be performed at the same time as eyelid repair as a one-stage procedure.

Shared buccal mucosal graft for simultaneous repair of severe upper and lower eyelid cicatricial entropion

ABSTRACTPurpose: Cicatricial entropion is typically an acquired condition that can affect the upper and lower eyelids. The purpose of this prospective study is to examine the effect of shared buccal mucosal grafts for simultaneous repair of severe upper and lower eyelid cicatricial entropion on eyelid position.Methods: Patients at the University of Texas-Southwestern Medical Center Aston Ophthalmology clinic were identified who were diagnosed with cicatricial entropion. Patients found to have severe upper and lower eyelid cicatricial entropion were included in the study if they had undergone or were scheduled to undergo simultaneous upper and lower eyelid repair through the use of a shared mucosal graft. Pre-operative exams which included pre-operative photos and description of eyelid position were performed. Shared mucosal graft surgery was performed. At post-operative week 1, the patients had splitting of their shared mucosal grafts. Post-operative photos as well as post-operative description of eyelid position were made at 6 weeks, 3 months, and 6 months.Results: At 6 months after surgical repair of severe upper and lower eyelid cicatricial entropion by shared mucosal grafts, patients were found to have resolution of entropic eyelid position as well improvement in ocular surface irritation. No adverse events were found and no graft failures occurred.Conclusions: The use of a shared mucosal graft for the repair of severe upper and lower eyelid entropion, when sufficient tarsal structural support is present, is effective for the correction of eyelid malpositions and ocular surface irritation.

Clinical and pathological analysis on eyelid tumors and repair approachs of the eyelid defect

Objective To analyze the clinical type and the pathological classification of eyelid tumor,and investigate the method of surgical resections and the repair approaches for the eyelid defects following extensive excision of eyelid tumor.Methods 73 eyes of 73 cases of eyelid tumor were retrospectively analyzed,according to histopathological diagnosis,treatment,prognosis,individual repair approaches for the eyelid defects.Results 62 cases were diagnosed with benign eyelid tumors,of which the common types are dermoid and epidermoid cyst,basal cell papilloma,granuloma,sebaceous cyst,intradermal nevi and compound nevi.11 cases were with malignant tuomrs,including 9 cases of basal cell carcinoma and 2 cases of aquamous cell carcinoma.All eyelid tumors underwent surgical resection,the repair approaches for the eyelid defects were:direct suturing skin (44 cases),suturing the release of cutting edge (15 cases),skin graft from the inside of the left upper arm (5 cases),lateral flap repairing (7 cases),inside flap repairing (1 cases),sliding tarsal conjunctival flap (1 case).All skin grafts and flaps were successful.During the followup,the malignant eyelid tumors hadn' t metastasized.Conclusion The majority of eyelid tumors is benign lesions.Basal cell carcinoma is the most common malignant lesions,surgical resection is an effective treatment.The repair approach for the eyelid defects following extensive excison is impomnant in maintaining eyelid shape,preventing eyelid deformities,keeping ocular surface function. Key words: Tumors, eyelid; Pathology; Surgery; Carcinoma, basal cell; Plasty, palpebral,flap, transplant