Abstract ID: 26-143
Management of a Full-Thickness Eyelid Defect following Posterior Ptosis Repair
Author: Mehmet Serhat Mangan Base Hospital / Institution: Istanbul University, Istanbul Faculty of Medicine, Department of Ophthalmology
Presentation Type: ePoster Presentation
Purpose
In this report, we describe a previously unreported complication of MMCR in a patient with aponeurotic ptosis.
Methods
A 63-year-old male patient was referred to ptosis of the left upper eyelid. Levator function was measured as 16 mm bilaterally. The margin-reflex distance (MRD) was 3 mm in the right eye and 1 mm in the left. Based on the patient’s clinical findings and medical history, a diagnosis of aponeurotic ptosis was made. A phenylephrine test was performed and Post-test MRD1 was 3 mm in both eyes, indicating a positive response. Therefore, MMCR was recommended.
Results
Surgery was performed under local anesthesia. Nine millimeters of conjunctiva and Müller muscle were marked and grasped with a Putterman ptosis clamp. After placement of the Putterman clamp, the skin was not checked. A 6-0 polypropylene suture was passed in a continuous horizontal mattress pattern ~1 mm below the clamp. The conjunctiva and Müller muscle were excised, and the suture was externalized and tied over a bolster.
Postoperative evaluation revealed a satisfactory eyelid aperture, as documented in photographs taken on postoperative
day 1 and day 5, before suture removal. However, following suture removal on postoperative day 10, a fullthickness eyelid defect measuring ~7 mm horizontally and 5 mm vertically was observed. The defect remained undetectable with the eyelids closed or in primary gaze, but became visible upon downgaze.
Following identification of the defect, revision surgery was scheduled. In the second postoperative week, a full-thickness
defect involving both the anterior and posterior lamellae was surgically repaired. Following resuturing, satisfactory eyelid
aperture was restored, and the wound demonstrated good healing and structural integrity. In addition, no postoperative
lagophthalmos or corneal epithelial keratopathy was observed.
Conclusion
This case highlights a novel complication of MMCR that has not been previously reported: delayed full thickness
wound dehiscence. Our experience underscores the importance of postoperative monitoring.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Emirhan | Ozkul | Sancaktepe Prof. Dr. Ilhan Varank Education and Research Hospital |
| Ceyhun | Arici | Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine |
| Merve Beyza | Yildiz | Haydarpasa Numune Education and Research Hospital |