Comparison of Free Tarsoconjunctival Grafts and Hughes Tarsoconjunctival Grafts for Lower Eyelid Reconstruction

Hawes, Michael J.; Grove, Arthur S.; Hink, Eric M.

doi:10.1097/iop.0b013e318217e194

Cited by 40 publications

(30 citation statements)

References 21 publications

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“…Hawes et al 6 describe very similar results to our findings, with free tarsoconjunctival graft and myocutaneous flap technique for reconstruction of moderate to large lower eyelid defects shown to be a reliable and effective practice. Their large retrospective review not only supports our conclusions, but demonstrates a much lower complication rate of this technique in comparison with patients having undergone Hughes' pedicled tarsoconjunctival flap reconstruction with full thickness skin graft.…”

Section: One-step Reconstruction Of Large Lower Eyelid Defects: Technsupporting

confidence: 88%

One‐step reconstruction of large lower eyelid defects: technique and outcomes

Katz

Pennington

Yohendran

et al. 2014

Clinical Exper Ophthalmology

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REFERENCES1. Kawasaki R, Wang JJ, Rochtchina E, Lee AJ, Wong TY, Mitchell P. Retinal vessel caliber is associated with the 10-year incidence of glaucoma: the Blue Mountains Eye Study. Ophthalmology 2013; 120: 84-90. 2. Sugiyama T, Araie M, Riva CE, Schmetterer L, Orgul S. Use of laser speckle flowgraphy in ocular blood flow research. Acta Ophthalmol (Copenh) 2010; 88: 723-9. 3. Aizawa N, Yokoyama Y, Chiba N et al. Reproducibility of retinal circulation measurements obtained using laser speckle flowgraphy-NAVI in patients with glaucoma. Clin Ophthalmol 2011; 5: 1171-6. 4. Aizawa N, Kunikata H, Yokoyama Y, Nakazawa T. Correlation between optic disc microcirculation in glaucoma measured with laser speckle flowgraphy and fluorescein angiography, and the correlation with mean deviation. Clin Experiment Ophthalmol 2014; 42: 293-4. 5. Shiga Y, Omodaka K, Kunikata H et al. Waveform analysis of ocular blood flow and the early detection of normal tension glaucoma. Inv Ophth Vis Sci 2013; 54: 7699-706.One-step reconstruction of large lower eyelid defects: technique and outcomesModerate to large lower eyelid defects following skin cancer excision or trauma present a challenge for the reconstructive surgeon. A myriad of techniques have been described in the literature; however, the goal remains to replace the missing anatomical layers and restore lower eyelid form and function. For the purpose of reconstruction, the lower eyelid is often divided into anterior and posterior lamellae: the posterior lamella, comprising tarsus and conjunctiva, provides protection to the eye by preventing conjunctival drying, providing a mechanical barrier to trauma and facilitating atraumatic eyelid closure with its lubricated, smooth surface. The anterior lamella, comprising skin and orbicularis oculi, provides an additional barrier and also facilitates eyelid movement. Large defects of the Competing/conflicts of interest: No stated conflict of interest. Funding sources: No stated funding sources.Figure 2. Box plot of vessel pixel count in the four study groups. Outlying values are included as small dots. The asterisks indicate statistically significant differences with normal eyes (Kruskal-Wallis test, followed by Steel-Dwass test; *P < 0.05, **P < 0.01).Figure 3. Box plot of area ratio of blood stream (ARBS) in the four study groups. Outlying values are included as small dots.The asterisks indicate statistically significant differences with normal eyes (Kruskal-Wallis test, followed by Steel-Dwass test; *P < 0.05; **P < 0.01).

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Section: One-step Reconstruction Of Large Lower Eyelid Defects: Technsupporting

confidence: 88%

One‐step reconstruction of large lower eyelid defects: technique and outcomes

Katz

Pennington

Yohendran

et al. 2014

Clinical Exper Ophthalmology

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“…Excellent results have been reported using tarsoconjunctival grafts for repairing defects of up to 75 percent of the eyelid length (Therapeutic: Level III Evidence). 20 Oversizing the graft should be avoided to prevent laxity, especially in lower lid reconstruction. Leaving a 2-mm conjunctival edge on the superior border of the graft is useful in forming the margin of the reconstructed lid (Therapeutic: Level III Evidence).…”

Section: Grafts In Eyelid Reconstructionmentioning

confidence: 99%

“…Leaving a 2-mm conjunctival edge on the superior border of the graft is useful in forming the margin of the reconstructed lid (Therapeutic: Level III Evidence). 20 Hard-palate mucoperiosteal grafts can be used to replace the posterior lamella due to their ability to provide structural support and mucosal lining. They have been shown to produce reliable results; however, donor-site morbidity can be problematic.…”

Section: Grafts In Eyelid Reconstructionmentioning

confidence: 99%

“…Tarsoconjunctival grafts are an excellent choice for posterior lamellar reconstruction, since they possess the features of a normal eyelid (Therapeutic: Level III Evidence). [16][17][18][19][20] They are harvested from the upper eyelid, leaving at least 3 to 4 mm of inferior tarsus to avoid upper lid deformity. The donor site heals spontaneously by secondary intention.…”

Section: Grafts In Eyelid Reconstructionmentioning

confidence: 99%

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Eyelid Reconstruction

Alghoul

Pacella

McClellan

et al. 2013

Plastic and Reconstructive Surgery

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Reconstruction of the eyelids after excision of skin cancer can be challenging. Knowledge of surgical eyelid anatomy and appropriate preoperative planning are critical in order to perform eyelid reconstruction and minimize complications and the need for reoperation. The fundamental principle for full-thickness eyelid reconstruction is based on reconstructing the subunits of the eyelid, including the anterior and posterior lamellae as well as the tarsoligamentous sling.

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“…Ebenso ist die Möglichkeit der Rekonstruktion beider Lamellen bei ausgedehnten Unterliddefekten mittels zweier gestielter Lappen (Mukosa und Haut-Muskel) im Sinne eines V-Y-Verschiebelappens beschrieben [22]. Im direkten Vergleich der freien mit den gestielten Tarsokonjunktivaltransplantaten (nach Hughes) zeigt sich, dass häufiger lidkantenrekonstruierende Eingriffe nach gestielten Transplantaten erforderlich sind, hier jedoch auch ursprünglich größere Unterliddefekte vorliegen [23]. Literatur…”

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