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Reconstructions of eyelid defects.

Subramanian N - Indian J Plast Surg (2011)

Bottom Line: Many a times, the defects involve more than one area.One layer should have the vascularity to support the other layer which can be a graft.A proper plan and execution of it is very important.

View Article: PubMed Central - PubMed

Affiliation: Professor Emeritus Oculoplastic Surgery. Sankara Nethralaya; Senior Plastic Surgeon Apollo Hospital, Retired Professor and Head of the Department of Burns, Plastic and Reconstructive Surgery Kilpauk Medical college and Hospital, Chennai, India.

ABSTRACT
Eyelids are the protective mechanism of the eyes. The upper and lower eyelids have been formed for their specific functions by Nature. The eyelid defects are encountered in congenital anomalies, trauma, and postexcision for neoplasm. The reconstructions should be based on both functional and cosmetic aspects. The knowledge of the basic anatomy of the lids is a must. There are different techniques for reconstructing the upper eyelid, lower eyelid, and medial and lateral canthal areas. Many a times, the defects involve more than one area. For the reconstruction of the lid, the lining should be similar to the conjunctiva, a cover by skin and the middle layer to give firmness and support. It is important to understand the availability of various tissues for reconstruction. One layer should have the vascularity to support the other layer which can be a graft. A proper plan and execution of it is very important.

No MeSH data available.


Related in: MedlinePlus

(a-c) Congenital coloboma direct approximation; ptosis seen in the immediate postoperative period clears
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Figure 2: (a-c) Congenital coloboma direct approximation; ptosis seen in the immediate postoperative period clears

Mentions: The lid has some inherent stretch ability due to which primary approximation of small defects can be done. Small central defects can be reconstructed by direct approximation. The defect is converted into a pentagon by making a perpendicular cut up to the upper border of the tarsus. The skin above is excised as an inverted “V.” Closure is done in layers with extra care for the marginal sutures. Notching can occur sometimes. If there is a dog-ear at the upper end it can be corrected with Z-plasty. This method is useful for the correction of congenital simple coloboma of the upper eyelid. If there is some tension, a cantholysis of the upper crus of the LCT can be done. Up to 25% defect of the upper eyelid can be closed in younger individuals and up to 40% in older individuals. Initially, there may be some ptosis which gets resolved in time [Figures 2a–c].


Reconstructions of eyelid defects.

Subramanian N - Indian J Plast Surg (2011)

(a-c) Congenital coloboma direct approximation; ptosis seen in the immediate postoperative period clears
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3111123&req=5

Figure 2: (a-c) Congenital coloboma direct approximation; ptosis seen in the immediate postoperative period clears
Mentions: The lid has some inherent stretch ability due to which primary approximation of small defects can be done. Small central defects can be reconstructed by direct approximation. The defect is converted into a pentagon by making a perpendicular cut up to the upper border of the tarsus. The skin above is excised as an inverted “V.” Closure is done in layers with extra care for the marginal sutures. Notching can occur sometimes. If there is a dog-ear at the upper end it can be corrected with Z-plasty. This method is useful for the correction of congenital simple coloboma of the upper eyelid. If there is some tension, a cantholysis of the upper crus of the LCT can be done. Up to 25% defect of the upper eyelid can be closed in younger individuals and up to 40% in older individuals. Initially, there may be some ptosis which gets resolved in time [Figures 2a–c].

Bottom Line: Many a times, the defects involve more than one area.One layer should have the vascularity to support the other layer which can be a graft.A proper plan and execution of it is very important.

View Article: PubMed Central - PubMed

Affiliation: Professor Emeritus Oculoplastic Surgery. Sankara Nethralaya; Senior Plastic Surgeon Apollo Hospital, Retired Professor and Head of the Department of Burns, Plastic and Reconstructive Surgery Kilpauk Medical college and Hospital, Chennai, India.

ABSTRACT
Eyelids are the protective mechanism of the eyes. The upper and lower eyelids have been formed for their specific functions by Nature. The eyelid defects are encountered in congenital anomalies, trauma, and postexcision for neoplasm. The reconstructions should be based on both functional and cosmetic aspects. The knowledge of the basic anatomy of the lids is a must. There are different techniques for reconstructing the upper eyelid, lower eyelid, and medial and lateral canthal areas. Many a times, the defects involve more than one area. For the reconstruction of the lid, the lining should be similar to the conjunctiva, a cover by skin and the middle layer to give firmness and support. It is important to understand the availability of various tissues for reconstruction. One layer should have the vascularity to support the other layer which can be a graft. A proper plan and execution of it is very important.

No MeSH data available.


Related in: MedlinePlus