Complications of Tarsoconjunctival Grafts

Hawes, Michael J.; Jamell, Gary A.

doi:10.1097/00002341-199603000-00007

Cited by 36 publications

(30 citation statements)

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“…64.7% of our patients had minor complications such as notching of the lid margin (11/17), trichiasis (2/17), epiphora (1/17), superficial punctate keratitis (6/17) and a mild tendency to ectropion (6/17) which did not require revision. This accords with previously published studies [2,4,22]. We did not see any major complications that would have required revision.…”

Section: Discussionsupporting

confidence: 93%

“…Full-thickness defects greater than 50% of the horizontal length of the upper or lower eyelid are often reconstructed by either Hughes or Cutler-Beard bridge flaps [2,3]. This can induce either major complications, including marked upper lid retraction after upper lid reconstruction, wound dehiscence, entropion, ectropion and excessive lower lid laxity, or minor complications, such as trichiasis, notching or mild eversion and inversion of the lid margin, symblepharon and corneal irritation with dry eye symptoms including punctate keratitis, epiphora, pain, redness, burning and foreign body sensation [4]. …”

Section: Introductionmentioning

confidence: 99%

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Dry Eye Symptoms in Patients after Eyelid Reconstruction with Full-Thickness Eyelid Defects: Using the Tomey TG-1000 Thermographer

et al. 2012

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Background: Large full-thickness eyelid defects are conventionally reconstructed by either a Hughes flap or Cutler-Beard bridge flap. Since the structure of the eyelid and its components are necessary for the tear film production and stability, we investigated the outcome after eyelid reconstruction focusing on dry eye symptoms using a new thermographic device, the TG-1000. Methods: Seventeen eyes of patients formerly treated with Hughes flaps (n = 16) and a Cutler-Beard bridge flap (n = 1) were compared to untreated healthy eyes (n = 17) regarding the functional and aesthetic outcome. The follow-up ranged from 3 to 63 months (mean 24.88 ± 17.86). Results: There was no significant difference in Schirmer’s test, break-up time and ocular surface temperature (p > 0.05) between patients after full-thickness eyelid reconstruction and a control group. Eleven patients had minor postoperative complications such as notching of the lid margin (11/17), epiphora (1/17), superficial punctate keratitis (6/17), trichiasis (2/17) and a mild tendency to eversion of the lid margin (6/17). More than 75% of the patients rated their postoperative aesthetic outcome as good or even excellent. Conclusion: The new TG-1000 device is a simple and quick tool for screening of dry eye. This study shows that tarsoconjunctival grafts offer good aesthetic and functional outcome with sufficient tear film composition and stability.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Dry Eye Symptoms in Patients after Eyelid Reconstruction with Full-Thickness Eyelid Defects: Using the Tomey TG-1000 Thermographer

et al. 2012

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“…The reconstructed lid margins have a normal appearance of uniform thickness (unlike that achieved after lateral cantholysis) and they have eyelashes along their whole length. The red margin, so often seen after posterior lamellar reconstruction,10 was notable by its absence. There was no contact of skin epithelium or skin hairs in with the cornea to cause irritation.…”

Section: Discussionmentioning

confidence: 97%

“…However, numerous complications have also been described. Hawes and Jamell10did a study looking into complications of tarsoconjunctival grafts in 44 patients. These include major complications like eyelid retraction, wound dehiscence, ectropion, and excessive lower lid laxity.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous eyelid expansion after full thickness eyelid resection and direct closure

Thaller¹

2001

British Journal of Ophthalmology

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Background/aims-Direct closure of eyelid defects gives excellent functional results but is usually restricted to defects measuring less than a quarter of the eyelid length for fear of distorting the palpebral aperture and compromising lid function. The authors have used direct closure in larger defects. The aim of this study was to establish the eVects of direct closure of full thickness eyelid margin defects under tension on the palpebral aperture dimensions. Methods-A consecutive series of patients who had undergone one eyelid, full thickness lid resection repaired by direct closure were identified and invited to have both eyes photographed. The palpebral apertures of both eyes were measured from the photographs by a masked observer. The amount of eyelid resected was recorded from the operation notes. The unoperated palpebral aperture was used as the control. The result were analysed using a paired samples t test. Results-The photographs of 18 patients were included in the analysis. The mean width of excised full thickness lid tissue was 15 mm (range 7-26 mm). The mean vertical palpebral aperture height was 9.2 (SD 1.4) mm in the operated eye as opposed to 9.3 (SD 1.2) mm in the non-operated eye. The mean horizontal palpebral aperture width was 26.1 (SD 1.9) mm in the operated eye as opposed to 26.4 (SD 1.8) mm in the non-operated eye. There was no statistically significant difference between the operated and unoperated horizontal and vertical palpebral measurements. Conclusions-Direct closure of large full thickness eyelid defects is possible in selected patients with excellent functional and cosmetic results. Eyelid tissue expansion occurs spontaneously following direct eyelid defect closure under tension, restoring the palpebral aperture dimensions.

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“…6 However, results are highly dependent on technique and surgeon, and in a report of another series of patients undergoing eyelid reconstruction using tarsoconjunctival grafts, cicatricial ectropion occurred in only 1 of 44 patients. 7…”

Section: Cicatricial Ectropionmentioning

confidence: 99%

Eyelid Complications Associated with Surgery for Periocular Cutaneous Malignancies

2020

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Periocular skin is highly prone to malignancies, especially basal cell and squamous cell carcinomas. Because of the complex anatomy and eye-protecting functions of the periocular tissues, treatment of these cancers requires special considerations. Mohs micrographic surgery is usually the treatment of choice, whenever possible, in order to enhance margin control while limiting collateral damage to nearby normal structures. Cancer excision, whether by Mohs or other techniques, will leave a complex defect that requires careful anatomical and functional reconstruction. This study presents some of the challenges of treating periocular skin cancer and associated reconstructive surgery and provides an intellectual framework for addressing these challenges. The key topics are adherence to anatomical landmarks and aesthetic units, proper distribution of tension, and matching the correct reconstructive approach, that is, type of flap or graft, to the defect at hand. This review is not meant to be exhaustive, but it will provide both basic and advanced considerations.

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Complications of Tarsoconjunctival Grafts

Cited by 36 publications

References 0 publications

Dry Eye Symptoms in Patients after Eyelid Reconstruction with Full-Thickness Eyelid Defects: Using the Tomey TG-1000 Thermographer

Dry Eye Symptoms in Patients after Eyelid Reconstruction with Full-Thickness Eyelid Defects: Using the Tomey TG-1000 Thermographer

Spontaneous eyelid expansion after full thickness eyelid resection and direct closure

Eyelid Complications Associated with Surgery for Periocular Cutaneous Malignancies

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