Reconstructive blepharoplasty following eyelid melanoma excision using a sliding skin flap in six horses

Abstract

Melanomas are common in grey horses, and the eyelid is one of the less common predilection sites. The eyelids play an important role in maintaining ocular health, and damage to the eyelid margin can lead to ocular complications, including ocular pain, conjunctivitis and ulcerative keratitis. Surgical procedures to remove eyelid tumours, therefore, often require reconstruction techniques to re-establish the eyelid's appearance and function.The sliding skin flap is a simple surgical technique that can be applied to close the defect resulting from surgical excision of eyelid tumours such as melanomas, but there is little published data about the short-and long-term outcomes of this procedure in the horse. This case report reviews six horses where a sliding skin flap was used to reconstruct the eyelid after excision of discrete eyelid melanomas, with short-and long-term follow-up of the cases. Short-term complications (including corneal abrasion from a suture) were uncommon (two cases), and there were no reported long-term complications (follow-up period 6 months to 13 years), with no melanoma recurrence at the surgical site. However, new melanoma development at other sites of the body occurred in several cases.

Standard and modified glabellar flap for medial canthus reconstruction following mass removal in three dogs and two cats

“…Other blepharoplasty procedures can be considered for managing skin defects in the medial canthal area of veterinary patients, including an axial pattern flap (dog with MCT), 6 local transposition cutaneous flap (cats with various eyelid tumors), 2 rhomboid blepharoplasty (horse with squamous cell carcinoma), 4 and H‐plasty (horse with melanoma) 5 . Good cosmetic outcomes and ocular surface health were achieved although trichiasis was also a common postoperative complication.…”

“…[2][3][4][5][6] In feline patients, Schmidt et al described a local transposition cutaneous flap following eyelid mass resection in five cats, three of whom with medial canthus involvement, 2 while Del Magno et al described a caudal auricular axial pattern flap to reconstruct the upper eyelid in three cats, one of whom with medial upper eyelid involvement. 3 A rhomboid blepharoplasty and an H-plasty were reported for the removal of squamous cell carcinoma and melanoma involving the medial canthus of equine patients, 4,5 respectively, while a temporal axial pattern flap was used to cover the medial canthal defect in a dog following mast cell tumor removal. 6 On the other hand, blepharoplasty of the medial canthus is well documented in human medicine, in part because medially located lesions are relatively common in human patients.…”

“…For eyelid defects located in the medial canthus region, only a handful of case reports are described in veterinary medicine 2–6 . In feline patients, Schmidt et al described a local transposition cutaneous flap following eyelid mass resection in five cats, three of whom with medial canthus involvement, 2 while Del Magno et al described a caudal auricular axial pattern flap to reconstruct the upper eyelid in three cats, one of whom with medial upper eyelid involvement 3 .…”

“…In feline patients, Schmidt et al described a local transposition cutaneous flap following eyelid mass resection in five cats, three of whom with medial canthus involvement, 2 while Del Magno et al described a caudal auricular axial pattern flap to reconstruct the upper eyelid in three cats, one of whom with medial upper eyelid involvement 3 . A rhomboid blepharoplasty and an H‐plasty were reported for the removal of squamous cell carcinoma and melanoma involving the medial canthus of equine patients, 4,5 respectively, while a temporal axial pattern flap was used to cover the medial canthal defect in a dog following mast cell tumor removal 6 . On the other hand, blepharoplasty of the medial canthus is well documented in human medicine, in part because medially located lesions are relatively common in human patients.…”

When is the upper worse than the lower?

“…The series described by Rose and Mair (2023) also points out the significant differences associated with the upper and lower eyelids.…”