Early cicatricial lagophthalmos release with pentagonal wedge resection of the scar, fat redistribution, and full-thickness skin grafting

Abstract

The specialized structure of the upper eyelid ensures complete closure of the eye and eyeball sealing. An upper eyelid injury can cause various symptoms associated with eyeball trauma, not just scar formation or eyelid deformity. In this report, we describe a case of lagophthalmos observed after wound repair in a patient with a crushing injury caused by a grinder. Several surgical techniques are used to treat lagophthalmos or scar contracture. In most cases, a releasing procedure is performed after 6 months of initial repair. However, if the patient has severe symptoms that are not relieved by conservative care, early revision is inevitable. We describe a case of early lagophthalmos successfully resolved with pentagonal wedge resection, fat redistribution, and full-thickness skin grafting. After the revisional surgery, we observed that the patient regained the ability to completely close the injured eyelid, with restoration of function and favorable cosmetic outcomes. Pentagonal wedge resection to release a retracted structure, fat redistribution to prevent readhesion, and full-thickness skin grafting for enough amount of skin to regain upper eyelid function is useful for scar release and lagophthalmos following crushing injuries of the upper eyelid.

Clinical association between serum cholesterol level and the size of xanthelasma palpebrarum

“…In most cases, simple excision followed by primary closure was enough. However, if the lesion had diffuse distribution, we performed local flap techniques or upper blepharoplasty in order to avoid eyelid deformity [ 4 , 6 , 11 ].…”

Surgical correction of a cicatricial lagophthalmos

“…If a severe contracture is present, local flaps can leave large unsightly scars and may not achieve adequate scar release. [ 2 ] The technique described achieved favorable functional and cosmetic outcomes in this patient.…”

“…In such cases, release of scar tissue and repositioning of the levator palpebrae superioris are critical steps for a successful treatment. [ 2 ]…”