Abstract :
Aims: To evaluate the usefulness of orbicularis bi-pedicle flap, a simple surgical technique to reconstruct shallow, upper or lower eyelid defects with loss of more than two-thirds of the lid tissue.
Materials and Methods: This prospective interventional study was conducted at a two tertiary referral centers in Lahore, Pakistan from Jan 2011 - Dec 2018. 17 consecutive cases were included: 4 primary, 9 with recurrent tumour and 4 secondary cases with an excised tumour and eyelid defect. The upper lid was affected in 6 cases and lower lid in 11 cases.
The median age of patients was 62 years (range 45 - 71 years), with 9 female and 8 male patients. The posterior lamella was reconstructed by mobilising forniceal conjunctiva while donor sclera was used to replace the tarsus. To reconstruct anterior lamella, orbicular bi-pedicle flap was mobilised, covered by a free skin graft.
Post-operative follow-up was after 1, 2 weeks and then after 1, 3, 6 months and 1 year. At each visit, functional, aesthetic, visual outcome and patient satisfaction was assessed.
Results: Patient satisfaction was 100%. Lagophthalmos in 3 cases (27%), 2 mm lid retraction in 2 cases (18%) following upper lid reconstruction. No complication noted after lower lid reconstruction.
Conclusions: Orbicularis bi-pedicle flap is a simple, single-staged technique, with short learning curve and minimal complications. It is particularly useful in single-eyed patients.
Keyword :
Lid reconstruction, Lid tumor excision, Lid margin defects, Orbicularis bipedicle flap.