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Successful Free Bilamellar Eyelid Grafts for the Repair of Upper and Lower Eyelid Defects in Patients and Laser Speckle Contrast Imaging of Revascularization

Tenland, Kajsa LU ; Berggren, Johanna LU orcid ; Engelsberg, Karl LU ; Bohman, Elin ; Dahlstrand, Ulf LU ; Castelo, Nazia LU ; Lindstedt, Sandra LU ; Sheikh, Rafi LU orcid and Malmsjö, Malin LU (2021) In Ophthalmic Plastic and Reconstructive Surgery 37(2). p.168-172
Abstract

PURPOSE: It is generally believed that large eyelid defects must be repaired using a vascularized flap for 1 lamella, while the other can be a free graft. Recent studies indicate that the pedicle of a tarsoconjunctival flap does not contribute to blood perfusion. The purpose of this study was to explore whether large eyelid defects can be repaired using a free bilamellar eyelid autograft alone.

METHODS: Ten large upper and lower eyelid defects resulting from tumor excision were reconstructed using bilamellar grafts harvested from the contralateral or opposing eyelid. Revascularization of the flap was monitored during healing using laser speckle contrast imaging, and the surgical outcome was assessed.

RESULTS: The functional... (More)

PURPOSE: It is generally believed that large eyelid defects must be repaired using a vascularized flap for 1 lamella, while the other can be a free graft. Recent studies indicate that the pedicle of a tarsoconjunctival flap does not contribute to blood perfusion. The purpose of this study was to explore whether large eyelid defects can be repaired using a free bilamellar eyelid autograft alone.

METHODS: Ten large upper and lower eyelid defects resulting from tumor excision were reconstructed using bilamellar grafts harvested from the contralateral or opposing eyelid. Revascularization of the flap was monitored during healing using laser speckle contrast imaging, and the surgical outcome was assessed.

RESULTS: The functional and cosmetic results were excellent. All grafts survived and there was no tissue necrosis. Only 1 patient underwent revision after 4 days as the sutures came loose. Two patients developed minimal ectropion but needed no reoperation. All patients were satisfied with the surgical results. Perfusion monitoring showed that the grafts were gradually revascularized, exhibiting 50% perfusion after 4 weeks and 90% perfusion after 8 weeks.

CONCLUSIONS: A free bilamellar eyelid graft appears to be an excellent alternative to the tarsoconjunctival flap procedure in the reconstruction of both upper and lower eyelid defects, especially in patients who cannot tolerate visual axis occlusion or the 2-stage procedure of the conventional staged flap procedure.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Ophthalmic Plastic and Reconstructive Surgery
volume
37
issue
2
pages
168 - 172
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:32467523
  • scopus:85102603685
ISSN
1537-2677
DOI
10.1097/IOP.0000000000001724
language
English
LU publication?
yes
id
a3f8ae39-139e-4be7-8ec1-a93bf4d1835d
date added to LUP
2020-06-04 16:52:43
date last changed
2024-06-26 16:04:44
@article{a3f8ae39-139e-4be7-8ec1-a93bf4d1835d,
  abstract     = {{<p>PURPOSE: It is generally believed that large eyelid defects must be repaired using a vascularized flap for 1 lamella, while the other can be a free graft. Recent studies indicate that the pedicle of a tarsoconjunctival flap does not contribute to blood perfusion. The purpose of this study was to explore whether large eyelid defects can be repaired using a free bilamellar eyelid autograft alone.</p><p>METHODS: Ten large upper and lower eyelid defects resulting from tumor excision were reconstructed using bilamellar grafts harvested from the contralateral or opposing eyelid. Revascularization of the flap was monitored during healing using laser speckle contrast imaging, and the surgical outcome was assessed.</p><p>RESULTS: The functional and cosmetic results were excellent. All grafts survived and there was no tissue necrosis. Only 1 patient underwent revision after 4 days as the sutures came loose. Two patients developed minimal ectropion but needed no reoperation. All patients were satisfied with the surgical results. Perfusion monitoring showed that the grafts were gradually revascularized, exhibiting 50% perfusion after 4 weeks and 90% perfusion after 8 weeks.</p><p>CONCLUSIONS: A free bilamellar eyelid graft appears to be an excellent alternative to the tarsoconjunctival flap procedure in the reconstruction of both upper and lower eyelid defects, especially in patients who cannot tolerate visual axis occlusion or the 2-stage procedure of the conventional staged flap procedure.</p>}},
  author       = {{Tenland, Kajsa and Berggren, Johanna and Engelsberg, Karl and Bohman, Elin and Dahlstrand, Ulf and Castelo, Nazia and Lindstedt, Sandra and Sheikh, Rafi and Malmsjö, Malin}},
  issn         = {{1537-2677}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{168--172}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Ophthalmic Plastic and Reconstructive Surgery}},
  title        = {{Successful Free Bilamellar Eyelid Grafts for the Repair of Upper and Lower Eyelid Defects in Patients and Laser Speckle Contrast Imaging of Revascularization}},
  url          = {{http://dx.doi.org/10.1097/IOP.0000000000001724}},
  doi          = {{10.1097/IOP.0000000000001724}},
  volume       = {{37}},
  year         = {{2021}},
}