The addition of a conjunctival flap to a posterior lamella auricular cartilage graft: A technique to avoid corneal complications

Abstract

Purpose: To present the benefits of the addition of a conjunctival flap when correcting lower eyelid retraction using an auricular cartilage graft. Methods: An auricular cartilage graft was obtained either from the concha o the scaphoid fossa. When preparing the receiving bed, the conjunctival incision was made 2 mm below the inferior margin of the lower eyelid tarsus, therefore, a conjunctival flap arising from the inferior border of the tarsus was obtained. The cartilage graft was placed in the lower eyelid. The inferior border of the graft was sutured to the retractors and conjunctiva using absorbable sutures. The superior border was sutured to the inferior tarsus, so that de conjunctival flap covered the superior portion of the graft. Results: Fourteen patients underwent the surgical technique. No corneal complications were observed in the early or late postoperative period. Donor site complications were not encountered. Conclusions: The confection of a conjunctival flap that lines the superior portion of an auricular cartilage graft in the lower eyelid provides protection against corneal postoperative complications until the graft is epithelized.

Polymers and Biomaterials for Posterior Lamella of the Eyelid and the Lacrimal System

“…Auricular cartilage grafts offer appropriate flexibility and strength [55,56]. Due to a low metabolic rate and minimal vascular requirements, they remain viable for many years post-implantation [55,56]. Yet, their rough surface may cause corneal irritation.…”

Biomaterials and tissue engineering strategies for posterior lamellar eyelid reconstruction: Replacement or regeneration?

“…Due to their lower metabolic rate and fewer vascular requirements, auricular cartilage grafts remain viable for many years after implantation. Thus, reconstruction of the posterior lamella with auricular cartilage grafts leads to a cosmetic contour and adequate support without significant graft absorption or shrinkage 72,73 . When auricular cartilage grafts are used for tarsoconjunctiva replacement, the conjunctival surface is missing and usually left for reepithelization, but the rough surface of the grafts may result in corneal irritation 74 .…”

“…Thus, reconstruction of the posterior lamella with auricular cartilage grafts leads to a cosmetic contour and adequate support without significant graft absorption or shrinkage. 72 , 73 When auricular cartilage grafts are used for tarsoconjunctiva replacement, the conjunctival surface is missing and usually left for reepithelization, but the rough surface of the grafts may result in corneal irritation. 74 Adding an oral mucosal graft for coverage could help solve this problem.…”

Tenzel flap for reconstruction of full-thickness inferior ocular defects following basal cell carcinoma resection: Case report

“…The development of basal cell carcinoma is caused by exposure to ultraviolet rays, genetic factors, age, scarring, and chronic skin damage. The studies by K. Taniguchi et al [3], C. Barrancos et al [4] found that sunlight exposure is the main environmental cause of BCC, with the development of the disease being related to the nature of the exposure. The disease has local growth and is characterised by painless spread to the surrounding tissues.…”