The Modified Abbé: A Lid Switch Flap to Reconstruct Traumatic Full-Thickness Upper Eyelid Defects
Author: Jordan Cornwell
Base Hospital / Institution: Kaiser Permanente Bernard J. Tyson School of Medicine
ePoster presentation
Abstract ID: 24-486
Purpose
Full-thickness upper eyelid trauma can have a devastating effect on eyelid function and aesthetic appearance. The authors review the etiology, surgical technique, and outcomes of upper eyelid reconstructions using a modified Abbé technique.
Methods
The authors present a case report of a traumatic full thickness upper eyelid reconstruction in a 23-year-old patient using a modified Abbé flap with 10 year follow up. A literature review was completed describing outcomes and complications of upper eyelid reconstruction cases using a similar technique.
Results
A post-traumatic full thickness lower lid pedicle was created, rotated 180 degrees, and fastened to the upper lid defect. Successful flap division occurred at 3 weeks with sustained patient satisfaction at 10 years. Etiology of the 49 cases reviewed included malignancy, congenital malformation, and trauma. All cases resulted in satisfactory aesthetic and functional outcomes with minimal complications. Notable complications included corneal irritation and lagophthalmos. Surgical revision occurred in 9/49 cases.
Conclusion
Post-traumatic eyelid reconstruction in younger patients presents unique challenges including minimal eyelid laxity, need for long term stable results, and heightened cosmetic concern. Reconstruction of full thickness upper eyelid defects involving 30-60% of the lid can be successfully accomplished using the modified Abbé flap. This technique allows for reliable functional and aesthetic outcomes in younger and older populations with retained patient satisfaction and functionality at 10 year follow up. Meticulous use of this reconstructive approach can result in excellent eyelid function and ocular survival. Successful and timely division of the flap has been shown in as short as 1-3 weeks and should be considered to minimize post-op complications.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Jeremie | Oliver | Mayo Clinic School of Medicine |
| Stacey | Francis | Craniofacial Services, Southern California Permanente Group |
