J Korean Ophthalmol Soc.  2018 Feb;59(2):110-116. 10.3341/jkos.2018.59.2.110.

The Cosmetic Effects of Full Thickness Eyelid Resection and Direct Closure for Eyelid Malignant Tumors

• Lee DE
• Jo SH
• Ham DS
• Lee JJ
• Yang JW

• KMID: 2403802
• DOI: http://doi.org/10.3341/jkos.2018.59.2.110

Abstract

PURPOSE
To evaluate the degree of eyelid deformation and satisfaction after direct closure in patients with 40-70% eyelid defects after resection of an eyelid malignant tumor.
METHODS
We retrospectively reviewed the clinical records of patients diagnosed with eyelid malignant tumors between January 2009 and June 2016, who were treated with resection of 40-70% of the eyelid, followed by reconstructed direct closure only or by direct closure with lateral canthotomy and cantholysis. Age, sex, diagnosis, tumor location, satisfaction, and complications were analyzed, and the ratio of horizontal width ratio and vertical height ratio were compared before and after surgery.
RESULTS
The results of satisfaction were: 12 patients (60%), very good; five patients (25%), good; and three patients (15%), fair. The average preoperative horizontal width ratio and vertical height ratio were 1.03 ± 0.01 and 1.08 ± 0.30, respectively. The average postoperative horizontal width ratio and vertical height ratio were 1.04 ± 0.08 and 1.01 ± 0.17, respectively There was no significant difference in horizontal width ratio or vertical height ratio before and after surgery (p = 0.314 and p = 0.087, respectively).
CONCLUSIONS
Eyelid reconstruction with a direct closure can be performed without a flap or graft for 40-70% of eyelid defects when resecting the eyelid of a malignant eyelid tumor.

Keyword

Direct closure; Eyelid reconstruction; Malignant eyelid tumor

MeSH Terms

Diagnosis
Eyelids*
Humans
Retrospective Studies
Transplants

Figure

• 

  Figure 1. An example of photograph. It shows how to measure vertical height ratio and horizontal width ratio in pre-operative photograph. The pre-operative horizontal width ratio of eyelid is obtained by dividing the horizontal width of eyelid in the contralateral (b) from the horizontal width of eyelid in the lesion (a). Pre-operative vertical height ratio of eyelid is obtained by dividing the vertical height of eyelid in the contralateral (d) from the vertical height of eyelid in the lesion (c). Pre-HR = pre-operative horizontal width ratio of eyelid; Pre-VR = pre-operative vertical height ratio of eyelid.

• 

  Figure 2. Statistical results box plots. It shows the distribution of horizontal ratio and vertical ratio of eyelid (y-axis) in preoperative and postoperative photographs (x-axis). The box plots show the median, interquartile range, 95% percentile, outliers, and extreme values. Pre op = in preoperative photographs; Post op = in postoperative photographs.

• 

  Figure 3. Patient's photographs included in the series. (A) The preoperative left lower lid squamous cell carcinoma, which measured 0.333 in its horizontal width ratio of eyelid mass. (B) The 3 month postoperative result after about 45% horizontal lid resection and direct closure. (C) Photograph also taken at 3 months and it allows a comparison with the normal unoperated right eye. (D) The pre-operative left lower lid sebaceous carcinoma, which measured 0.318 in its horizontal width ratio of eyelid mass. (E) The 3 month postoperative result after about 41% horizontal lid resection and direct closure. (F) Photograph also taken at 3 months and it allows a comparison with the normal unoperated right eye.

Reference

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