Functional Outcome in Reconstruction of Eyelid Defects

Abstract

Introduction: Eyelid defects can be congenital, post

traumatic, post infective and post tumour excision.1,4

Reconstruction of eyelid defects is a challenge posed to

plastic surgeons. Defects of eyelid need to be

reconstructed in such a way that it should maintain the

function of eyelid and also have an aesthetically pleasing

outcome. Reconstruction requires providing an anterior

skin cover, intervening support and posterior mucosal

lining.1,2,3,4,5 Careful planning needs to be done to fulfill the

goals. Aim of study: To assess the functional outcome in

reconstruction of eyelid defects. Patients & Methodology:

The study was conducted from December 2015 to October

2016. 10 cases of eyelid defects were included in our

study in which reconstruction was done based on partial or

full thickness loss and percentage of loss. Various local

flaps and skin grafts were done according to the type of

loss. Postoperatively, functional outcome was assessed by

the presence of punctal eversion, epiphora, conjunctival

and corneal exposure. Patients were followed up for a

period of 6months. Results: Of the 10cases, 6 cases had

upper eyelid reconstruction, 3 cases had lower eyelid

reconstruction and 1 case had the medial canthal region

reconstructed. Reconstruction becomes challenging when

it is full thickness loss and the percentage of loss

increases. Upper eyelid defect reconstruction was more

difficult as compared to lower eyelid. 2 cases developed

corneal erosion initially which were treated conservatively.

Functional restoration was obtained in all cases. Aesthetic

appearance was better with lower eyelid reconstruction

than upper eyelid. Conclusion: Eyelid reconstruction

following loss is challenging. Early and effective

reconstruction results in a fairly normal functional and

acceptable aesthetic outcome.