Objective: To present our innovative limboconjunctival flap technique in the surgical treatment of primary pterygium and evaluate its effectiveness and safety.Methods: Thirty three eyes of 32 patients diagnosed with primary pterygium were included in this study. Cases with primary pterygium extending ≥3 mm into the cornea were analyzed in this prospective study. Patients with recurrent pterygium, double-head pterygium, and suspected malignity cases were excluded. A limboconjunctival flap prepared from the upper nasal conjunctiva adjacent to the area of excision was pulled over the scleral bed and fixed with three separated 8.0 vicryl sutures.Results: Fifteen of the patients (46.87%) were male and 17 were female (53.1%). The mean age of the patients was 47.9 (42-69) years. No intraoperative complication was observed. The mean postoperative follow-up period was 5.2 months (1-6 months). In all cases, the corneal epithelial defect improved within a week. Ten (76.9%) cases were successfully repaired, while in one case, the flap was displaced 0.5 mm toward the cornea. In addition, two recurrences were observed. Conclusion:We suggest that our innovative technique can be an alternative approach in the surgical management of primary pterygium because of its easy practicability, rapid postoperative rehabilitation, and improved patient satisfaction. However, larger-scale comparative studies are required to establish the effectiveness and safety of this technique. (JAREM 2015; 5: 17-21)

Objective: To evaluate the outcomes of various methods for surgical reconstruction of upper and lower eyelids after tumor excision.Methods: Data from 147 cases that were operated on due to tumors of the upper or lower eyelids between 2007 and 2011 were retrospectively analyzed. Surgical success was described as defect closure, proper valve function, appropriate lid contour, and good cosmetic appearance. Postoperative follow-up was performed on the 1st day and 1st week and every month afterwards. Results:The mean duration of follow-up was 8.9 months (6-36 months). Types of surgical interventions consisted of elliptical excision, sutureless excision, rotational flap, advancement flap, Tenzel flap, and blepharoplasty. Scarring at the medial canthus, lid contour deformity, and trichiasis were the complications encountered in the postoperative period. Winking reflex was preserved, and complete closure of eyelids was provided in all of the patients. The overall rate of surgical success was found to be 94.6%. Conclusion:Reconstruction of eyelids is an important issue after the complete excision of a tumor and achievement of tumor-free margins. The reconstructive technique must be appropriate for the location and the size of the lesion, aiming to provide a proper shape and contour for the eyelids. (JAREM 2014; 4: 97-101) Key Words: Flap, graft, eyelid, tumor, surgery, reconstruction ÖZET Amaç: Alt ve üst göz kapağın malign tümöral kitlelerinİn ekzisyonu uygulandıktan sonra oluşan göz kapağı defektlerinde uygulanan rekonstrüksiyon teknikleri ve klinik sonuçlarını değerlendirmek amaçlandı.Yöntemler: 2007 ve 2011 yılları arasında üst veya alt göz kapaklarında tümöral kitle nedeniyle eksizyon yapılan 147 olgunun verileri retrospektif olarak analiz edildi. Cerrahi başarı defektlerin tamamen kapanması, düzgün kapak fonksiyonu, uygun kapak kontur ve iyi kozmetik görünüm sağlanması olarak değerlendirildi. Ameliyat sonrası takip 1. gün, 1. hafta ve sonrasında aylık olarak yapıldı. Bulgular: Takip süresi ortalama 8,9 ay (6-36 ay) idi. Kullanılan cerrahi rekonstruksiyon teknikleri eliptik eksizyon, sütürsüz eksizyon, rotasyonel flep, ilerletme flebi, Tenzel flep ve blefaroplasti idi. Medial kantusta yara izi, kapak kontur deformitesi ve trikiyazis postoperatif dönemde karşılaşılan komplikasyonlardı. Göz kırpma refleksi tüm olgularda korundu .Göz kapaklarının tam kapanması bütün olgularda sağlandı. Cerrahi başarı oranı % 94,6 idi.Sonuç: Göz kapaklarının tümöral kitlelerinin tam eksizyonu sonrası düzgün kapak kontur ve pozisyonunun sağlanması önemlidir. Rekonstrüksiyon teknikleri göz kapakları için uygun bir şekil ve kontur sağlamayı amaçlamalı, lezyonun yerleşimine ve büyüklüğüne uygun olmalıdır. (JAREM 2014; 4: 97-101)