Friday, March 11, 2011

Reconstruction of a Poorly Repaired Upper Eyelid Trauma

The patient discussed in the previous blog underwent eyelid reconstruction yesterday. There are several ways that the eyelid could be repaired, the one used here was my own choice and other oculoplastic surgeon might well do it differently. The main reason I chose this technique was because the scars will be confined to the upper eyelid. The other techniques that can be used in this case include pentagon excision of the peaked eyelids followed by reconstruction using reversedTenzel's flap or McGregor's flap, however, these techniques will create additional scarring outside the upper eyelid.

The upper eyelids were marked to create two sliding flaps.

Creation of the sliding flaps. Note the retraction is partially 
released due to the release of the contracted skin.

The scarred and poorly apposed eyelid was removed 
through pentagon excision.

 Following the pentagon excision.

The two ends of the eyelids were apposed accurately.

At the conclusion of the repair.

The two sliding flaps were sutured in a Z fashion to lighten 
the wound.

The eye 24 hours after the surgery. The eye is closed with 
4/0 silk to prevent excessive eyelid movement 
which may affect the viability of the flaps.

The postoperative result will be shown in future blog.

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