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Key Issues When Reconstructing Extensive Upper Eyelid Defects With Description of a Dynamic, Frontalis Turnover Flap
Christopher M Stewart1, Lee Teak Tan, David Johnson
1*Oxford Eye Hospital, and †Department of Plastic and Reconstructive Surgery, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.
Ophthalmic Plastic and Reconstructive Surgery
|May 25, 2016
Summary
Reconstructing large upper eyelid defects is challenging. An innervated frontalis turnover flap with grafts offers a cosmetically acceptable solution, preserving function and visual acuity.
Area of Science:
- Ophthalmology
- Plastic Surgery
- Reconstructive Surgery
Background:
- Reconstructing full-thickness, total upper eyelid defects presents significant challenges.
- Achieving both acceptable cosmesis and dynamic function is difficult with existing techniques.
- Current options include eyelid-sharing or non-bridging techniques with varying success rates.
Observation:
- The success of eyelid reconstruction depends on defect size, cosmesis, and preserved dynamic function.
- Dynamic function is crucial to prevent ptosis and exposure keratopathy.
- Existing methods may not fully restore both form and function.
Findings:
- A novel technique using an innervated frontalis turnover flap supporting anterior and posterior lamella grafts is presented.
- This method addresses extensive upper eyelid defects.
- The technique is reported to be cosmetically acceptable and preserves local tissues.
Implications:
- This reconstructive solution maintains a degree of dynamic upper eyelid function.
- It ensures patient eye comfort and avoids adverse effects on visual acuity.
- The technique offers a promising approach for challenging upper eyelid reconstructions.
