Application of allogeneic sclera combined with tarso-conjunctival flap in total excision of divided eyelid nevus.

OBJECTIVE: To explore the clinical effect of allogeneic sclera transplantation combined with tarso-conjunctival flap in total excision of divided eyelid nevus. METHODS: Eleven patients (three male and eight female patients) who experienced divided nevus of the eyelids between January 2014 and April 2020 were recruited to this retrospective study. All lesions were thick, darkly pigmented, presented with a wart-like appearance, and invaded the eyelid margin and tarsal conjunctiva. The surgical method involved a full-thickness lesion excision; then, the posterior defect was reconstructed by sliding the residual tarso-conjunctival flap forward and allogeneic sclera transplantation, and the anterior defect was reconstructed with sliding flaps, rotating flaps, and free skin grafts. RESULTS: Neither malignant transformations nor recurrences were observed after a follow-up of more than one year. The eyelid shape was normal, the rim of the eyelid was smooth, there was no dissolution or rejection of the allogeneic sclera, and the eyelid had good mobility. All the flaps used were viable, soft, and thin. The most frequent complication was the loss of eyelashes in the reconstructed area. CONCLUSION: For divided nevus of the eyelids invaded the eyelid margin and tarsal conjunctiva, total excision is a better decision, regardless of tumor recurrence or aesthetic considerations. The posterior defect reconstruction through sliding residual tarso-conjunctival flaps combined with allogeneic sclera transplantation is simple and effective.

Effect of allogeneic sclera transplantation combined with arbitrary flap plasty in the treatment of moderate and severe deep and full-thickness eyelid defect / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the application and therapeutic effect of allogeneic sclera transplantation combined with arbitrary flap plasty in the treatment of moderate and severe deep and full-thickness eyelid defect.<p>METHODS: Medical records of 103 patients(103 eyes)who underwent allogeneic scleral transplantation combined with random flap plasty in the treatment of moderate and severe deep and full-thickness eyelid defect from June 2017 to June 2020 were retrospectively reviewed. All patients were followed up for 1-6mo after operation was performed to evaluate the postoperative effects of the resorption and compatibility of allogeneic sclera, the survival situation of skin flaps, eyelid appearance, eyelid closure, eyelid scar.<p>RESULTS: Follow up observation from 1-6mo after operation, the allogeneic sclera was gradually replaced by the receptor tissue, allogeneic sclera in the inner layer of the eyelid was covered with conjunctival cells, allogeneic sclera and skin join closely together in the outer layer of the eyelid. There was no rejection in allogeneic sclera. All patients had survived skin flaps, good eyelid shape, natural eyelid closure, and no scars.<p>CONCLUSION: The allogeneic sclera transplantation combined with random flap plasty has curative effect in the repair of moderate and severe deep and full-thickness eyelid defect. It has both function and aesthetics result, and it is suitable for clinical promotion.

Clinical observation on allogeneic scleral transplantation for tarsus defect after the operation of eyelid malignant tumor / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the clinical effect of allogeneic scleral graft in reconstruction of defective tarsus after resection of malignant tumor of eyelid. <p>METHODS: We replaced the tarsus with allogeneic sclera and performed eyelid reconstruction in 24 eyes(24 cases)with defective tarsus after eyelid malignant tumor operation. In these cases, the length of defective tarsus was greater than 1/2 and the allogenic sclera material was selected from eyebank. <p>RESULTS: All patients were followed up for 3-12mo after operations. The shape was good after eyelid reconstruction and there was no dissolution or rejection in allograft sclera. The choroid was covered with conjunctival cells. Allogeneic sclera and skin join closely together and the defective area was completely repaired. Four eyes have mild to moderate eye lids margin inversion, and the inverted eyelid were corrected. Two eyes were with different degrees of eyelid ball adhesion so the separation operation was taken. <p>CONCLUSION: The allogeneic sclera has the advantages of good material stability, good biocompatibility, convenient conservation of materials, and easy operation. The eyelid is with good function and satisfactory appearance after operation, which is the ideal substitute material of tarsus.