The first Use of Mitek Micro-Anchor® in Medial Canthal Reconstruction Following Moh’s Surgery for Periocular Tumor Resection: A Novel Approach
Author: Giulia Filippello
Base Hospital / Institution: Newcastle Upon Tyne United Kingdom/ Royal Victoria Infirmary Hospital
ePoster presentation
Abstract ID: 24-339
Purpose
This case study highlights the pioneering use of the Mitek Micro-Anchor® system in oculoplastic surgery for the reconstruction of the medial canthal tendon (MCT) following extensive Moh’s micrographic surgery. We aim to demonstrate how this innovative technique enables reconstruction without the use of periosteum, potentially reducing the need for extensive grafts and enhancing postoperative recovery.
Methods
A 52-year-old male patient with extensive deep margins underwent Moh’s micrographic surgery, resulting in the loss of the upper and lower crus of the MCT and periosteum. As the lesion advanced into the orbit, further resection under general anesthesia was necessary. Fresh samples of periosteum, fat, and orbicularis muscle were obtained and examined microscopically and via frozen section to ensure clear margins. Upon confirmation of negative margins, the reconstruction of the medial canthus began. The placement of the Mitek Micro-Anchor® was meticulously planned and executed. A hand-held micro burr was used to drill the insertion site, and the anchor, preloaded with double-ended 3/0 absorbable sutures, was securely placed into the bone. The integrity of the anchor was tested to ensure stability, and a second anchor was placed to replicate the placement of the upper crus. The sutures were used to anchor tissues for the reformation of the posterior lamella of the eyelids. Further reconstruction involved a glabella flap and a naso-jugal island flap. The final anchor fixated the glabellar flap tip to the bone.
Results
Six months postoperatively, the patient expressed high satisfaction with the outcome, despite experiencing epiphora. The reconstruction provided effective protection for the healthy eye and achieved a cosmetically and functionally satisfactory result.
Conclusion
This case marks the first reported use of the Mitek Micro-Anchor® system in oculoplastic surgery for medial canthus reconstruction. The innovative technique allows for reconstruction without the use of periosteum, reducing the need for extensive grafts and minimizing morbidity. This approach shortens anesthetic time, enables quicker rehabilitation, and results in less bulky reconstruction, which is particularly beneficial in the delicate periocular region. Our findings suggest that the Mitek Micro-Anchor® system is a viable option for complex reconstructive procedures in challenging anatomical zones, offering enhanced protection for ocular health and improved patient satisfaction.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Lucy | Clarke | Newcastle Upon Tyne United Kingdom/ Royal Victoria Infirmary Hospital |
| Romeela | Rana-Rahman | Newcastle Upon Tyne United Kingdom/ Royal Victoria Infirmary Hospital |
| Paul | Meredith | Newcastle Upon Tyne United Kingdom/ Royal Victoria Infirmary Hospital |
