Eyelid Reconstruction Using a Monopedicle Flap and Buccal Mucosa: Report of 15 Cases

Whitehouse, Geoffrey M.; Francis, Ian C.

doi:10.1111/j.1442-9071.1988.tb01231.x

Cited by 18 publications

(5 citation statements)

References 12 publications

(2 reference statements)

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“…Eyelid reconstructive in humans that utilize free oral mucosal flaps are well-established. [52][53][54][55][56][57] However, the use of this free graft technique in veterinary literature is limited. Previously described use of this technique includes case reports of an upper eyelid repair in a horse following full-thickness melanoma excision, upper eyelid reconstruction following surgical trauma in a dog, and a case series of 13 eyes in seven cats to repair feline eyelid agenesis.…”

Section: Resultsmentioning

confidence: 99%

“…Vascular anastomoses will begin to develop in the revascularization phase (days 4–11), and within 7 days a network of vessels begin penetrating the graft tissue, which signals the beginning of the tissue maturation phase (day 11–42). Eyelid reconstructive surgeries in humans that utilize free oral mucosal flaps are well‐established 52–57 . However, the use of this free graft technique in veterinary literature is limited.…”

Section: Discussionmentioning

confidence: 99%

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Use of subdermal hyaluronic acid injections and a free labial mucocutaneous graft for the repair of feline eyelid agenesis

Caruso¹,

Reynolds²,

Whittaker³

et al. 2021

Veterinary Ophthalmology

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Objective: To describe a technique to repair feline eyelid agenesis using a hyaluronic acid (HA) subdermal filler injection to allow for acute soft tissue expansion, followed by a free labial mucocutaneous graft. Materials and methods:Thirty-nine colobomatous eyelids in 24 feline patients with secondary keratitis were recruited to the study group.Results: Keratitis and trichiasis were markedly resolved in 27/39 (69.2%) eyelids after a single procedure. Post-operative HA subdermal filler injections were required to resolve 5/39 (12.8%) eyelids that had mild post-operative trichiasis, and 1/39 (2.5%) eyelids that had post-operative lateral canthal collapse. Complications occurred in 6/39 (15.4%) cases, consisting of distal graft necrosis (n = 2 eyes), suture rubbing the cornea (n = 2 eyes), moderate trichiasis (n = 1 eye) and graft adherence to the episclera (n = 1 eye). Conclusion:The technique was successful in enhancing corneal protection, cosmesis and eyelid function and should be considered as a surgical option for any degree of eyelid agenesis in feline patients.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Use of subdermal hyaluronic acid injections and a free labial mucocutaneous graft for the repair of feline eyelid agenesis

Caruso¹,

Reynolds²,

Whittaker³

et al. 2021

Veterinary Ophthalmology

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show abstract

“…Although the oral mucosal graft does not provide production of the mucosal component of the tear film due to the absence of goblet cells, 12 the remaining conjunctiva would compensate such a minor functional deficit. 13 This prefabricated graft harvest is extremely easy, and its donor-site morbidity is among the lowest within all of the techniques using cartilage grafts and might be proposed as an alternative for patients who underwent previous septoplasty.…”

Section: Discussionmentioning

confidence: 99%

Prefabricated Composite Graft for Eyelid Reconstruction

et al. 2015

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The authors propose a prefabricated chondromucosal composite graft to reconstruct full-thickness defects of the lower eyelid. The technique was used in a patient suffering from a locally invasive basal cell carcinoma of the lower eyelid, who had previously undergone an extensive submucosal nasal septum resection. One week prior to the eyelid resection, the anterior skin surface of the auricular concha was replaced with a full-thickness oral mucosa graft. One week later, a full-thickness excision of the right lower eyelid was performed and the prefabricated chondromucosal auricular graft was used to restore the posterior lamella. The anterior lamella was reconstructed with a bipedicled myocutaneous flap from the upper eyelid. Because of the patient's scheduling needs, the medial pedicle of the flap was divided 28 days later and the lateral one after further 37 days. All the procedures were performed under local anesthesia. This technique adds a simple key detail to other time-honored reliable techniques, thus outlining an extremely convenient sequence for full-thickness eyelid reconstruction. The easily prepared prefabricated chondromucosal graft might be associated with any of the previously described flaps, thus providing a versatile and reliable method of posterior lamella reconstruction.

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“…The main disadvantage is that hard palate mucosa is best harvested with the patient sedated or under general anaesthesia, therefore may not be suitable for all patients. Buccal mucosa grafts25 may be more easily harvested under local anaesthesia but do not provide structural support per se in the lower lid. Other autogenous grafts include auricular cartilage,14 which may be harvested in small amounts from the concha under local anaesthesia, and free tarsoconjunctival grafts21 24 which are also easily harvested, but healing of the donor site may theoretically exacerbate upper eyelid retraction.…”

Section: Discussionmentioning

confidence: 99%

“…Surgery to correct lower eyelid retraction may include either a graft or a non-graft technique 1-24. Grafts may be autogenous—for example, as hard palate mucosa,13 15 20 auricular cartilage,14 tarsal conjunctiva,21 24 and buccal mucosa,25 or may be from an exogenous donor such as sclera. Donor sclera has a risk of transmission of HIV or slow viruses, may be of limited availability and may not be acceptable to the patient for ethical reasons.…”

mentioning

confidence: 99%

Correction of lower eyelid retraction in thyroid eye disease: a randomised controlled trial of retractor tenotomy with adjuvant antimetabolite versus scleral graft

Olver

Rose

Khaw

et al. 1998

British Journal of Ophthalmology

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Background/aims-Lower eyelid retraction in thyroid eye disease contributes to ocular discomfort and an unsightly appearance, especially if asymmetrical. The use of donor scleral grafts is eVective in lengthening the lower eyelids but carries a risk of virus transmission. Other techniques, including those which do not use grafts, need to be compared with scleral grafts. Recurrent retraction is a recognised complication of thyroid eyelid surgery; therefore, the authors investigated the use of antimetabolites to reduce postoperative fibrosis. Methods-In this prospective randomised controlled trial of 25 patients (35 eyelids), the use of donor sclera in 20 lower eyelids (13 patients) was compared with partial tenotomy of the anterior part of the lower eyelid retractors (ALER) with adjuvant peroperative antimetabolite in 15 lower eyelids (12 patients). A 5 minute peroperative application of either 5-fluorouracil (25 mg/ml) in nine lower eyelids (eight patients) or mitomycin C (0.2 mg/ml) in six lower eyelids (four patients) was used to focally inhibit fibroblasts. Follow up ranged from 3 to 18 months (mean 7.8). Results-One month after surgery the results of both groups were similar. However, at 3 months after surgery the results of scleral grafting were better than tenotomy with antimetabolites: 3/12 patients (25%) treated with tenotomy and adjuvant antimetabolite required subsequent surgery using grafts for correction of recurrent retraction. There were no significant complications associated with the use of antimetabolites in the eyelid in the doses used in this study. Conclusions-This randomised prospective trial shows that donor scleral grafts were more eVective in the long term than partial tenotomy with adjuvant antimetabolite in the correction of lower eyelid retraction associated with thyroid eye disease. The use of peroperative antimetabolites in the lower eyelid was safe. (Br J Ophthalmol 1998;82:174-180)

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Eyelid Reconstruction Using a Monopedicle Flap and Buccal Mucosa: Report of 15 Cases

Abstract: Abstract

Cited by 18 publications

References 12 publications

Use of subdermal hyaluronic acid injections and a free labial mucocutaneous graft for the repair of feline eyelid agenesis

Use of subdermal hyaluronic acid injections and a free labial mucocutaneous graft for the repair of feline eyelid agenesis

Prefabricated Composite Graft for Eyelid Reconstruction

Correction of lower eyelid retraction in thyroid eye disease: a randomised controlled trial of retractor tenotomy with adjuvant antimetabolite versus scleral graft

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