Ikoma Tokiyoshi, Amagata Yoko, Fujii Kazuyasu, Aoki Megumi, Tozawa Takahisa, Iwata Masashi, Yamamura Kentaro, Hirano Yui, Sakamoto Shoichi, Matsushita Shigeto
Department of Dermato-Oncology, NHO Kagoshima Medical Center, Kagoshima, Japan.
J Dermatol. 2025 Sep;52(9):1465-1469. doi: 10.1111/1346-8138.17872. Epub 2025 Jul 21.
The treatment of skin malignancies of the lower eyelid presents unique challenges due to the thin skin, proximity to vital structures, and the functional importance of the eyelid. Although surgical excision remains the standard approach for such malignancies, lower eyelid reconstruction is critical for preserving both function and aesthetics. Free tarsoconjunctival grafts (FTGs) have emerged as effective options for posterior lamellar reconstruction, providing structural support and long-term stability. This retrospective study analyzed cases of lower eyelid reconstruction using FTGs between December 2014 and November 2024. Eleven cases met the inclusion criteria, all of which involved basal cell carcinoma (BCC). During this period, 115 lower eyelid BCC cases were treated, and FTGs were selectively applied in 9.6% of cases. Grafts were harvested from the ipsilateral upper eyelid, with dimensions ranging from 5 to 11 mm in width and 3 to 5 mm in height. Postoperative outcomes, including complications, graft dimensions, and tumor recurrence, were evaluated. No major complications were observed. Minor complications occurred in three cases: one patient developed trichiasis at the graft site, and two patients experienced mild corneal epithelial damage. However, none of the patients reported subjective symptoms related to these complications. At a mean follow-up of 19.3 months, no tumor recurrence was observed, although one patient died of unrelated causes. These findings highlight the suitability of FTGs for small to moderately sized defects. Careful graft size selection leads to favorable outcomes with minimal complications. Overall, FTGs are a reliable and safe option for lower eyelid reconstruction, balancing oncological safety, functional preservation, and aesthetic outcomes in conservative surgical approaches for BCC treatment.
由于下眼睑皮肤薄、靠近重要结构且眼睑功能重要，下眼睑皮肤恶性肿瘤的治疗面临独特挑战。尽管手术切除仍是此类恶性肿瘤的标准治疗方法，但下眼睑重建对于保留功能和美观至关重要。游离睑板结膜移植术（FTG）已成为后层重建的有效选择，可提供结构支撑和长期稳定性。这项回顾性研究分析了2014年12月至2024年11月期间使用FTG进行下眼睑重建的病例。11例符合纳入标准，均为基底细胞癌（BCC）。在此期间，共治疗了115例下眼睑BCC病例，其中9.6%的病例选择性应用了FTG。移植物取自同侧上眼睑，宽度为5至11毫米，高度为3至5毫米。评估了术后结果，包括并发症、移植物尺寸和肿瘤复发情况。未观察到重大并发症。3例出现轻微并发症：1例患者移植部位出现倒睫，2例患者出现轻度角膜上皮损伤。然而，所有患者均未报告与这些并发症相关的主观症状。平均随访19.3个月，未观察到肿瘤复发，不过有1例患者死于无关原因。这些发现凸显了FTG适用于中小尺寸缺损。仔细选择移植物大小可带来良好结果，并发症最少。总体而言，FTG是下眼睑重建的可靠且安全的选择，在BCC治疗的保守手术方法中平衡了肿瘤学安全性、功能保留和美学效果。
