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The 'over-the-top' modified Cutler-Beard procedure for complete upper eyelid defect reconstruction
Saul N Rajak1,2, Raman Malhotra3, Dinesh Selva2
1a The Sussex Eye Hospital , Brighton and Sussex University Hospital , Brighton , UK.
Orbit (Amsterdam, Netherlands)
|March 8, 2018
Summary
The Over-the-Top Modified Cutler Beard Procedure (OTTMCB) offers effective upper eyelid reconstruction for large defects. This two-stage technique provides good functional and cosmetic results, improving upon traditional methods.
Area of Science:
- Ophthalmology
- Plastic Surgery
- Reconstructive Surgery
Background:
- Complete upper eyelid defects pose significant reconstructive challenges.
- Existing methods may have limitations in achieving optimal functional and aesthetic outcomes.
Purpose of the Study:
- To describe the 'Over-the-Top' Modified Cutler Beard Procedure (OTTMCB) for complete upper eyelid defect reconstruction.
- To evaluate the efficacy of the OTTMCB in cases of large upper eyelid defects.
Main Methods:
- Retrospective case note review of four patients undergoing the OTTMCB procedure.
- A two-stage procedure involving a free tarsal graft for the posterior lamella and a lower eyelid skin flap for the anterior lamella.
Main Results:
- The OTTMCB was used for defects ranging from 75-90% of the upper eyelid following tumor excision.
- Three out of four patients achieved good functional and cosmetic outcomes.
- One patient required revision surgery for dehiscence, cosmesis, and lagophthalmos.
Conclusions:
- The OTTMCB procedure effectively reconstructs both anterior and posterior lamellae using 'like-for-like' tissues.
- This modified technique offers advantages over the original Cutler-Beard procedure and its variations.
- The OTTMCB achieves favorable cosmetic results in upper eyelid reconstruction.