Oral abstract presentation times

Purpose

To report techniques and results using porcine dermal matrix (PDM) as a tarsal substitute to repair Mohs surgery eyelid margin defects.

---

Methods

After IRB approval, a chart review was performed on patients treated between 2008 and 2025.

---

Results

PDM was used as the sole tarsal substitute in 72 lower lid repairs. Mean margin defect width was 12.8mm (6-23mm). Advancement conjunctival flaps covered the posterior PDM surfaces. Anterior lamellae were reconstructed with skin flap (53%), skin graft + orbicularis flap (35%), combined skin flap + graft (12%).

Minor secondary procedures were needed for marginal erythema (n=5), trichiasis (n=3), milia (n=4), pyogenic granuloma (n=1). 89% of patients were asymptomatic at last visit. Among the 61 defects isolated to the margin, surgery did not alter the canthi, fissure width, or upper lid. 79% of the reconstructed lids were symmetrically positioned, while 17% had ≤1mm relative retraction. Lash line irregularity was noticeable in 37%. Functional results were graded: excellent: 94%, good: 3%, fair: 3%. Cosmetic results were rated from photographs: excellent: 54%, good (mild asymmetry) 39%, fair (noticeable asymmetry): 6%, poor: 1%.

PDM was used in 19 additional cases to repair the upper lid (n=6), combined upper-lower lid defects (n=2), and to augment the tarsus in cases treated with other methods (n=11). Among all 91 cases, there were no PDM infections or complications attributable to the material. The PDM remained stable without signs of resorption.

---

Conclusion

In selected patients, PDM is an effective tarsal substitute, providing good functional and cosmetic results, comparable to other techniques. It can permit single stage repair of larger defects, while maintaining a natural fissure without disruption of the lateral canthus or other lids.

---

Additional Authors

First name	Last name	Base Hospital / Institution
Robi	Maamari	WashU Medicine, St louis, MO, USA

↑ Back to top