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Abstract
Purpose
The purpose of this article is to describe successful reconstruction of upper eyelid defect using a composite graft from the contralateral eyelid.
Case summary
A 42-year-old-female patient presented with pigmented mass of the left upper tarsoconjunc- tiva. She underwent tumor resection and eyelid reconstruction with periosteal flap due to recurred malignant melanoma on her left lower conjunctiva 3 years ago. The left upper eyelid was reconstructed using a composite graft from the contralateral upper eyelid.
Conclusions
A satisfactory result, both functionally and cosmetically, was obtained during the follow-up period of 10 months. Composite graft isan ideal option for the reconstruction of eyelid defect which is difficult to correct successfully with other conventional methods. A case of eyelid reconstruction using a composite graft from the contralateral eyelid is herein reported with good functional and cosmetic results.
References
1. Jordan DR, Anderson RL, Nowinski TS. Tarsoconjunctival flap for upper eyelid reconstruction. Arch Ophthalmol. 1989; 107:599–603.
2. Werner MS, Olson JJ, Putterman AM. Composite grafting for eyelid reconstruction. Am J Ophthalmol. 1993; 116:11–6.
3. Callahan A. The free composite lid graft. AMA Arch Ophtha- lmol. 1951; 45:539–45.
4. Putterman AM. Viable composite grafting in eyelid recon- struction. Am J Ophthalmol. 1978; 85:237–41.
5. Hughes WH. Reconstruction of the lids. Am J Ophthalmol. 1945; 28:1203–11.
6. Putterman AM. Combined viable composite graft and temporal semicircular skin flap procedure. Am J Ophthalmol. 1984; 98:349–54.
7. Anderson RL, Edwards JJ. Reconstruction by myocutaneous eyelid flaps. Arch Ophthalmol. 1979; 97:2358–62.
8. Doxanas MT. Orbicularis muscle mobilization in eyelid recon- struction. Arch Ophthalmol. 1986; 104:910–4.
9. Patrinely JR, O’Neal KD, Kersten RC, Soparkar CN. Total upper eyelid reconstruction with mucosalized tarsal graft and overlying bipedicle flap. Arch Ophthalmol. 1999; 117:1655–61.
10. Beyer-Machule CK, Shapiro A, Smith B. Double composite lid reconstruction: a new method of upper and lower lid recon- struction. Ophthal Plast Reconstr Surg. 1985; 1:97–102.
11. A Mohammad Ael-N The use of composite lid graft and the adjacent temporal myocutaneous tissue with orbicularis muscle mobilization for full-thickness total and subtotal upper lid reconstruction. Orbit. 2005; 24:87–93.
12. Ahn K, Kim YD. Reverse modified hughes procedure for reconstruction of upper eyelid. J Korean Ophthalmol Soc. 2002; 43:1833–40.
Figure 1.
(A) Preoperative photograph. The tarsoconjunctiva of the left upper eyelid is involved by black-pigmented mass. (B) Full-thickness upper eyelid defect is created after the resection of the tumor. (C) Full-thickness pentagonal resection of the opposite upper eyelid. (D) The donor eyelid defect is closed primarily in the standard fashion. (E) Skin and orbicularis oculi muscle are undermined and removal from the pretarsal fascia 2 mm above the cilia of composite graft. (F) Composite graft composed of the eyelid margin, tarsus, and conjunctiva. (G) The composite graft is then placed and sutured into the coloboma site. (H) Graft is covered with a myocutaneous flap to replace the previously removed anterior lamella. (I) Postoperative photograph six months after the composite graft.
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