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Experience in upper eyelid reconstruction with the Cutler-Beard technique
T Fischer1, G Noever, M Langer
1Department of Plastic, Reconstructive, and Hand Surgery, Kantonsspital, Aarau, Switzerland.
Annals of Plastic Surgery
|September 20, 2001
Summary
The Cutler-Beard procedure reconstructs upper eyelid defects using lower eyelid tissue. Modifying this technique with an inlay graft can improve outcomes for extensive upper eyelid reconstructions.
Area of Science:
- Ophthalmology
- Plastic Surgery
Background:
- Reconstructing full-thickness upper eyelid defects requires a movable lid for corneal protection and good aesthetics.
- The Cutler-Beard procedure is a standard technique using an inferiorly based advancement flap.
Observation:
- The Cutler-Beard procedure offers good color and texture match, especially in older patients with lax lower eyelid skin.
- Potential complications include lower eyelid ectropion and upper eyelid retraction or entropion.
Findings:
- The Cutler-Beard procedure is a reliable method for upper eyelid defect reconstruction.
- Implantation of an inlay graft (e.g., sclera, fascia lata, cartilage) is recommended for extended defects to enhance stability.
Implications:
- Modifying the Cutler-Beard procedure with an inlay graft can mitigate complications and improve functional and aesthetic outcomes in complex upper eyelid reconstructions.
- This approach is particularly beneficial for extensive defects requiring additional structural support.