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Surgical reconstruction of medial eyelid defects using margin transposition, tarsal graft, and periosteal strip.

Orbit 2024 March 12
PURPOSE: Surgical reconstruction of medially located lower eyelid defects can be challenging. The Hughes procedure, considered the standard for reconstruction in such cases, often falls short in terms of cosmetic outcomes. An alternative approach that combines medial transposition with a tarsal graft and periosteal strip has shown promise. Here, we aim to demonstrate the cosmetic advantages of medial transposition of a preserved temporal lower eyelid over other techniques.

METHOD: We conducted a retrospective study involving seven well-documented patients who underwent the procedure described below. The study was approved by the University's Ethics Committee.

RESULTS: All patients were followed up for one year. Lower eyelid defects spanned 50-80% of their total length, situated in the central third of the eyelid or the central to medial portion. Postoperative complications were minimal, with all patients exhibiting good cosmetic, functional, and anatomical outcomes at follow-up.

CONCLUSION: The absence of eyelashes is well tolerated if it is lateral, but when the defect is medial, medial transposition could be a good alternative to the familiar Hughes surgical intervention.

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