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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 and b) Medial defect and medial advancement of tarsoconjunctival flap attachment to the posterior lip of the lacrimal fossa (congenital symblephron - cryptophthalmos)
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Figure 3: (a and b) Medial defect and medial advancement of tarsoconjunctival flap attachment to the posterior lip of the lacrimal fossa (congenital symblephron - cryptophthalmos)

Mentions: Defects of the upper eyelid which are medial and up to 30% in length can be directly approximated. The medial end of the defect must be freshened and the medial end of the tarsus anchored to the periosteum of the posterior lip of the lacrimal bone. Usually, the upper canaliculus is not available. But if the lower punctum and canaliculus is available, it is enough for lacrimal drainage. If there is some tension, a full thickness tarsoconjunctival flap can be advanced and anchored to the medial wall of the orbit. Incision is made through the entire thickness of the lid just above the tarsal plate and it is mobilized medially. The length of the incision is dependent on the extent to which the lid has to be moved. A lateral cantholysis further eases the mobilization. The posterior side of the flap is sutured to the periosteum of the medial wall of the orbit and the anterior side is sutured to the skin in the medial canthal area. [Figure 3 a–b]


Reconstructions of eyelid defects.

Subramanian N - Indian J Plast Surg (2011)

(a and b) Medial defect and medial advancement of tarsoconjunctival flap attachment to the posterior lip of the lacrimal fossa (congenital symblephron - cryptophthalmos)
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: (a and b) Medial defect and medial advancement of tarsoconjunctival flap attachment to the posterior lip of the lacrimal fossa (congenital symblephron - cryptophthalmos)
Mentions: Defects of the upper eyelid which are medial and up to 30% in length can be directly approximated. The medial end of the defect must be freshened and the medial end of the tarsus anchored to the periosteum of the posterior lip of the lacrimal bone. Usually, the upper canaliculus is not available. But if the lower punctum and canaliculus is available, it is enough for lacrimal drainage. If there is some tension, a full thickness tarsoconjunctival flap can be advanced and anchored to the medial wall of the orbit. Incision is made through the entire thickness of the lid just above the tarsal plate and it is mobilized medially. The length of the incision is dependent on the extent to which the lid has to be moved. A lateral cantholysis further eases the mobilization. The posterior side of the flap is sutured to the periosteum of the medial wall of the orbit and the anterior side is sutured to the skin in the medial canthal area. [Figure 3 a–b]

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