Rajabi Mohammad Taher, Bazvand Fatemeh, Hosseini Seyedeh Simindokht, Makateb Ali, Rajabi Mohammad Bagher, Tabatabaie Syed Ziaeddin, Abrishami Yalda
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran.
Int J Ophthalmol. 2014 Jun 18;7(3):507-11. doi: 10.3980/j.issn.2222-3959.2014.03.22. eCollection 2014.
To report the clinical outcomes of utilizing a three-layer flap and graft in reconstruction of the lower lid in one session.
Seventeen patients with total or near total lower eyelid defect were included. The defects were reconstructed in three layers. Posterior lamella was reconstructed by using tarsoconjunctival free graft from the ipsilateral upper lid and periosteal flap from lateral orbital rim. Mobilization of residual orbicularis muscle provided a rich blood supply; and the anterior lamella was reconstructed by skin flap prepared from upper lid blepharoplasty as a one-pedicular or bipedicular bucket handle flap.
The cause of lower eyelid defect was basal cell carcinoma in 15 patients and trauma in two of them. No intraoperative and postoperative complication occurred. Patients were followed from 10 to 15mo postoperatively. Cosmetic results were favorable in all patients and we had acceptable functional results. Thickness of the reconstructed tissue was a concern in early postoperative period.
Three-layer lower lid reconstruction in one session is an effective technique for total lower lid reconstruction with minimal complications and acceptable functional and aesthetic outcomes and can be considered as a safe alternative for the preexisting techniques.
报告一次性使用三层皮瓣和移植物重建下眼睑的临床效果。
纳入17例全层或近全层下睑缺损患者。缺损分三层进行重建。后层通过取自同侧上睑的睑板结膜游离移植物和眶外侧缘骨膜瓣重建。残余眼轮匝肌的动员提供了丰富的血供；前层通过上睑成形术制备的皮瓣作为单蒂或双蒂桶柄状皮瓣进行重建。
15例下睑缺损的病因是基底细胞癌，2例是外伤。术中及术后均未发生并发症。术后对患者进行了10至15个月的随访。所有患者的美容效果良好，功能结果也可接受。术后早期重建组织的厚度是一个问题。
一次性进行三层下睑重建是全层下睑重建的有效技术，并发症最少，功能和美学效果可接受，可被视为现有技术的安全替代方法。
