TYPES OF PROCEDURES REQUIRED FOR RECONSTRUCTION AND REPAIR OF EYE LID DEFECTS

Repair of Eye Lid Defects

Abstract

Objective: To analyze the causes of lid defects and different types of surgical procedures required for reconstruction / repair of these defects in a referral/teaching Armed Forces hospital. 
Study Design: Retrospective noncomparative case series and retrospective, nonrandomized, comparative interventional case series 
Place and Duration of Study: Combined Military Hospital Kharian, One year – 2007. 
Patients and Methods: Thirty one procedures for lid repair /reconstruction done in 25 lids of 23 eyes (21 patients) were analyzed. Age ranged from six months to seventy five years. Only congenital, traumatic and post surgical (after removal of tumors / scars) lid defects were included. Cases of ectropion, entropion, ptosis, where there were no surgical defects, were excluded. All the patients were photographed pre and post operatively. Follow up ranged from 1 month to 22 months. 
Results: Of 25 lids, defects were congenital in 4 (16 %), after removal of scars in 3 (12 %), after removal of tumors in 4 (16 %) and traumatic in 14 (56 %). The 31 procedures included direct closure 38.7%, ateral canthotomy and cantholysis 12.9%, Tenzel semicircular flap 9.7%, canalicular intubation with DCR tube 6.4%, graft from buccal mucosa 6.4%, cartilage from nasal septum to correct posterior lamella defect 6.4%, separation of lid skin from conjunctiva/cornea 6.4%, posterior auricular skin flap to correct anterior lamella defect 9.7% and lids formation by suturing of the lid margin 3.2%. 
Conclusion: Trauma is the most common aetiology of lid defects and most of the lid defects can be managed by direct closure. However some require different additional procedures.