Our experience with the masquerade procedure for total eyelid loss

Area of Science:

• Ophthalmology
• Plastic Surgery
• Reconstructive Surgery

Background:

• The Masquerade Procedure is a historical surgical technique for eyelid reconstruction with limited modern literature.
• This procedure is considered for complex cases where traditional eyelid reconstruction methods are not feasible.

Observation:

• The Masquerade Procedure was performed in two patients with extensive periocular tissue loss due to trauma.
• Case 1 involved a de-gloving injury with total eyelid loss, requiring a modified approach for corneal protection.
• Case 2 presented with severe facial burns and bilateral eyelid loss, complicated by corneal exposure and keratinization.

Findings:

• The first patient experienced corneal ulceration post-procedure, necessitating further reconstructive surgery with a cheek flap and a small aperture for vision.
• The second patient underwent two attempts at the Masquerade Procedure, with partial and complete failure attributed to poor blood supply.
• Successful corneal coverage was achieved in the first patient, preserving navigational vision.

Implications:

• The Masquerade Procedure can be a viable option in extreme reconstructive scenarios.
• Multiple surgical interventions and further reconstructive procedures may be necessary following the Masquerade Procedure.
• Careful patient selection and management are crucial for optimizing outcomes in these complex cases.