Title | A Modified Lateral Periosteal Flap for Reconstruction of Eyelid Defects |
Submitted by | Katja Ullrich |
Abstract Number | 312 |
19-153 | |
Review Result | poster presentation |
Purpose | In reconstruction of the lower eyelid defects, it is essential to achieve good eyelid position with appropriate vectors of the lateral eyelid, to achieve good functional and cosmetic outcomes. |
Methods | We describe a technique of using periosteum from the lateral orbital rim to replace the tarsal plate. The full thickness eyelid defect should be no more than 30%. The periosteal flap can be combined with other techniques if the defect is larger. The lateral orbital rim is exposed with the aid of a lateral canthotomy if needed. The length of the defect is assessed: the periosteal flap should be short enough to put the eyelid on mild traction but long enough to avoid undue tension and possible dehiscence. |
Results | We present 7 patients ranging in age from 61-93 years (mean age 78 years). The periosteal flap was combined with a free tarsal graft in 2 patients and a Hughes flap in 1 patient. At the first postoperative follow-up (approximately 2 weeks) 5 patients (71%) had similar or only slightly different eyelid contour and all 7 patients (100%) had a normal eyelid vector. At the most recent follow-up, all 7 patients had normal or only slightly different eyelid contour and all 7 patients (100%) had a normal eyelid vector. Follow up was 9-18 months. Complications included dehiscence requiring repeat repair (n = 1) and suture allergy (n = 1). Only one patient reported post-operative discomfort. |
Conclusion | A modified approach to creating a periosteal flap from the lateral orbital rim can involve less dissection whilst providing similar outcomes to traditional approaches. |
Additional Authors
Last name | Initials | City / Hospital | Department |
---|---|---|---|
Litwin | A | Queen Victoria Hopsital NHS Trust | Corneoplastics Unit |