Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.
Ophthalmic Plast Reconstr Surg. 2013 May-Jun;29(3):227-30. doi: 10.1097/IOP.0b013e3182831c84.
The Cutler-Beard procedure is a commonly used technique to reconstruct large upper eyelid defects. Eyelid retraction and entropion are common complications. To prevent these problems, the authors modified the traditional Cutler-Beard procedure with secondary placement of an autologous tarsoconjunctival graft.
This is a retrospective review of 2 patients with large upper eyelid defects necessitating upper eyelid reconstruction. The initial stage is unaltered. At the time of flap division, a tarsoconjunctival graft from the contralateral upper eyelid is sutured to the posterior surface of the newly constructed upper eyelid. Two patients underwent this procedure, and follow up was 4 and 23 months, respectively. Patients developed no postoperative complications, including entropion or retraction.
This modification to the Cutler-Beard operation is a technically simple procedure that can restore a more anatomically correct eyelid and can prevent subsequent entropion or retraction. This technique is unique, offering 3 major advances: first, placing the graft at the second surgical stage; second, replacing the tarsus and conjunctiva with like tissue; and third, preserving a lip of conjunctiva to cover the edge of the newly reconstructed upper eyelid.
Cutler-Beard 手术是一种常用于重建大面积上眼睑缺损的技术。眼睑退缩和倒睫是常见的并发症。为了预防这些问题，作者对传统的 Cutler-Beard 手术进行了改良，在二期时放置自体睑板结膜移植物。
这是对 2 例需要进行上睑重建的大面积上睑缺损患者的回顾性研究。初始阶段不变。在皮瓣分离时，从对侧上睑切取睑板结膜移植物，缝合到新构建的上睑的后表面。2 例患者均接受了该手术，随访时间分别为 4 个月和 23 个月。患者术后均无并发症，包括倒睫或退缩。
对 Cutler-Beard 手术的这种改良是一种技术简单的手术，可以重建更符合解剖结构的眼睑，并可预防随后发生的倒睫或退缩。该技术具有 3 个独特优势：首先，将移植物置于二期手术时放置；其次，用类似组织替代睑板和结膜；最后，保留结膜边缘以覆盖新构建的上睑边缘。
