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Professor Malin Malmsjö, MD, PhD. Photo.

Malin Malmsjö

Professor

Professor Malin Malmsjö, MD, PhD. Photo.

Successful Free Bilamellar Eyelid Grafts for the Repair of Upper and Lower Eyelid Defects in Patients and Laser Speckle Contrast Imaging of Revascularization

Author

  • Kajsa Tenland
  • Johanna Berggren
  • Karl Engelsberg
  • Elin Bohman
  • Ulf Dahlstrand
  • Nazia Castelo
  • Sandra Lindstedt
  • Rafi Sheikh
  • Malin Malmsjö

Summary, in English

PURPOSE: It is generally believed that large eyelid defects must be repaired using a vascularized flap for 1 lamella, while the other can be a free graft. Recent studies indicate that the pedicle of a tarsoconjunctival flap does not contribute to blood perfusion. The purpose of this study was to explore whether large eyelid defects can be repaired using a free bilamellar eyelid autograft alone.

METHODS: Ten large upper and lower eyelid defects resulting from tumor excision were reconstructed using bilamellar grafts harvested from the contralateral or opposing eyelid. Revascularization of the flap was monitored during healing using laser speckle contrast imaging, and the surgical outcome was assessed.

RESULTS: The functional and cosmetic results were excellent. All grafts survived and there was no tissue necrosis. Only 1 patient underwent revision after 4 days as the sutures came loose. Two patients developed minimal ectropion but needed no reoperation. All patients were satisfied with the surgical results. Perfusion monitoring showed that the grafts were gradually revascularized, exhibiting 50% perfusion after 4 weeks and 90% perfusion after 8 weeks.

CONCLUSIONS: A free bilamellar eyelid graft appears to be an excellent alternative to the tarsoconjunctival flap procedure in the reconstruction of both upper and lower eyelid defects, especially in patients who cannot tolerate visual axis occlusion or the 2-stage procedure of the conventional staged flap procedure.

Department/s

  • Ophthalmology Imaging Research Group
  • Ophthalmology, Lund
  • Clinical Sciences, Helsingborg
  • StemTherapy: National Initiative on Stem Cells for Regenerative Therapy
  • Thoracic Surgery
  • Clinical and experimental lung transplantation
  • NPWT technology

Publishing year

2021

Language

English

Pages

168-172

Publication/Series

Ophthalmic Plastic and Reconstructive Surgery

Volume

37

Issue

2

Document type

Journal article

Publisher

Lippincott Williams & Wilkins

Topic

  • Ophthalmology
  • Surgery

Status

Published

Research group

  • Ophthalmology Imaging Research Group
  • Clinical and experimental lung transplantation
  • NPWT technology

ISBN/ISSN/Other

  • ISSN: 1537-2677