Abstract ID: 26-378
A technique to contour ear cartilage graft for better lid & globe apposition
Author: Chameera Bandara Base Hospital / Institution: National Eye Hospital Sri Lanka, Colombo
Presentation Type: ePoster Presentation
Purpose
To describe a technique for contouring ear cartilage graft (ECG) to improve lid-globe apposition in eyelid reconstruction.
Methods
Introduction: Ear cartilage grafts are well described for reconstructing the posterior lamella of eyelids. However, limitations of this method include graft rigidity and difficulty in contouring it to match the curvature of underlying globe. Proper molding is important to ensure proper contact between the posterior lid surface and the globe and to prevent chronic ocular surface issues with unsatisfied patients. The technique described here aims to overcome above limitations and enhance graft globe apposition.
Methods: This case report includes patients with medium to large full thickness eyelid defects where ECG were considered either during primary repair or second stage sandwich grafting following initial Cutler-Beard procedures. In this technique, the graft was harvested along with posterior perichondrium. A series of smooth incisions were made perpendicular to the long axis at 2-3mm intervals in a controlled fashion ensuring underlying perichondrium remained intact. This created a flexible “cartilage chain” composed of multiple cartilage segments interconnected by the perichondrium. The graft was placed between the anterior lamella and the conjunctiva with the perichondrium facing the globe and secured in place.
Results
Post-operative assessment demonstrated good lid-globe apposition with no significant ocular surface irritation or related symptoms.
Conclusion
The Ear Cartilage Graft in the form of a “cartilage chain” seems to be an effective technique for reconstructing eyelid defects. Enrolling more cases and long term follow up would provide insight to potential limitations, possible improvements and long-term success of the technique.