Saul N Rajak1,2, Raman Malhotra3, Dinesh Selva2. 1. a The Sussex Eye Hospital , Brighton and Sussex University Hospital , Brighton , UK. 2. b South Australian Institute of Ophthalmology , Royal Adelaide Hospital , Adelaide , Australia. 3. c Corneoplastic Unit , Queen Victoria Hospital NHS Trust , East Grinstead , UK.
Abstract
PURPOSE: To describe the 'Over-the-Top' Modified Cutler Beard Procedure (OTTMCB) for complete upper eyelid defect reconstruction Methods: This is retrospective case note review of four patients that underwent the OTTMCB procedure. This two-stage procedure comprises the replacement of the posterior lamella with a free tarsal graft from the contralateral upper eyelid, and the anterior lamella with a lower lid skin flap over the lower eyelid margin which is divided 2-4 weeks later. RESULTS: The procedure was undertaken for four patients with 75-90% upper eyelid defects from tumour excision surgery. One patient had post-operative dehiscence requiring debridement and resuturing and further reconstructive surgery 18 months later to improve the cosmesis and lagophthalmos. The other three patients had good functional and cosmetic outcomes. CONCLUSIONS: The OTTMCB procedure replaces the anterior and posterior lamellae of the upper eyelid with 'like-for-like' tissues. It avoids some of the drawbacks of the original and other variations of the Cutler-Beard procedure and achieves a good cosmetic outcome.
PURPOSE: To describe the 'Over-the-Top' Modified Cutler Beard Procedure (OTTMCB) for complete upper eyelid defect reconstruction Methods: This is retrospective case note review of four patients that underwent the OTTMCB procedure. This two-stage procedure comprises the replacement of the posterior lamella with a free tarsal graft from the contralateral upper eyelid, and the anterior lamella with a lower lid skin flap over the lower eyelid margin which is divided 2-4 weeks later. RESULTS: The procedure was undertaken for four patients with 75-90% upper eyelid defects from tumour excision surgery. One patient had post-operative dehiscence requiring debridement and resuturing and further reconstructive surgery 18 months later to improve the cosmesis and lagophthalmos. The other three patients had good functional and cosmetic outcomes. CONCLUSIONS: The OTTMCB procedure replaces the anterior and posterior lamellae of the upper eyelid with 'like-for-like' tissues. It avoids some of the drawbacks of the original and other variations of the Cutler-Beard procedure and achieves a good cosmetic outcome.