Types of procedures required for reconstruction and repair of eye lid defects

ABSTRACT

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. Retrospective noncomparative case series and retrospective, nonrandomized, comparative interventional case series Combined Military Hospital Kharian, One year - 2007. 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. 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%. 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