Abstract ID: 26-178
Serial Vertical Tarsotomies to enable Direct Closure of Moderate to Large Full-thickness Eyelid Defects
Author: Simerdip Kaur Base Hospital / Institution: Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, RH19 3DZ, UK
Presentation Type: ePoster Presentation
Purpose
Direct closure of eyelid defects is traditionally limited to small defects of less than a third of the horizontal eyelid length due to concern regarding distortion of the palpebral aperture and risking eyelid malposition. We describe a simple, reproducible technique using serial vertical full-thickness posterior tarsotomy incisions to lengthen the residual eyelid. This facilitates direct closure of larger defects avoiding the need for Tenzel, Macgregor and in selected cases, even Hughes flaps.
Methods
Single-centre retrospective case series of patients undergoing eyelid reconstruction following periocular tumour excision. Serial vertical full-thickness tarsotomies were performed in the residual tarsus to increase eyelid length and facilitate direct closure. Patient demographics, tumour characteristics, defect size, reconstructive techniques and complications were recorded.
Results
Ten patients were included with a mean age of 78.5 years (range 65–93). Six (60%) patients were female and basal cell carcinoma accounted for 90% of tumours. The lower eyelid was involved in 80% of cases. Defects ranged from one-third to two-thirds of the horizontal eyelid length, with the majority (70%) involving more than half of the eyelid. Additionally, internal lateral cantholysis was performed in 8 cases and direct closure was achieved in all cases. Median follow-up was 3months (range 3–6 months). Postoperative complications occurred in three patients, including corneal irritation requiring temporary bandage contact lens wear (n=1) and mild ectropion (n=2). There were no cases of wound dehiscence or sight-threatening complications.
Conclusion
Serial vertical tarsotomies represent a unique technique to increase eyelid length and facilitate direct closure of moderate-to-large eyelid margin defects. This approach offers favourable functional and aesthetic outcomes and may represent a paradigm shift in eyelid reconstruction of full thickness defects.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Raman | Malhotra | Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, RH19 3DZ, UK |