Abstract
Aims We describe a variation of the Cutler–Beard flap in the reconstruction of upper eyelid defects.
Methods The technique of upper eyelid reconstruction with a free tarsal graft and a cutaneous lower eyelid advancement flap divided at 2 weeks is described. Four cases where this technique was used for reconstruction of eyelid defects due to periocular malignancy are also reported.
Results There were three male and one female patients ranging in age from 61 to 78 years. The underlying diagnoses were squamous cell carcinoma, trichilemmal carcinoma, and two basal cell carcinomas. Follow-up of 6–28 months revealed a good outcome in all four cases with one patient developing a mild cicatricial lower eyelid ectropion that was managed conservatively.
Conclusions A modified Cutler–Beard flap with free tarsal graft and early division may provide an effective alternative for upper eyelid reconstruction in cases with sufficient lower eyelid skin laxity.
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References
Cutler NL, Beard C . A method for partial and total upper lid reconstruction. Am J Ophthalmol 1955; 39: 1–7.
Carrol RP . Entropion following the Cutler-Beard procedure. Ophthalmology 1983; 90: 1052–1055.
Mauriello JA, Antonacci R . Single tarsoconjunctival flap (lower eyelid) for upper eyelid reconstruction (‘reverse’ modified Hughes procedure). Ophthalmic Surg 1994; 25: 374–378.
Leone CR . Tarsal-conjunctival advancement flaps for upper eyelid reconstruction. Arch Ophthalmol 1983; 101: 945–948.
Jordan DR, Anderson RL, Nowinski TS . Tarsoconjunctival flap for upper eyelid reconstruction. Arch Ophthalmol 1989; 107: 599–603.
Wesley RE, McCord CD . Transplantation of eyebank sclera in the Cutler–Beard method of upper eyelid reconstruction. Ophthalmology 1980; 87: 1022–1028.
Kersten RC, Anderson RL, Tse DT, Weinstein GL . Tarsal rotational flap for upper eyelid reconstruction. Arch Ophthalmol 1986; 104: 918–922.
Anderson RL, Edwards JJ . Reconstruction by myocutaneous eyelid flaps. Arch Ophthalmol 1979; 97: 2358–2362.
McNab AA, Martin P, Benger R, O'Donnell B, Kourt G . A prospective randomized study comparing division of the pedicle of modified Hughes flaps at two or four weeks. Ophthalmic Plast Reconstr Surg 2001; 17: 317–319.
Bartley GB, Messenger MM . The dehiscent Hughes flap: outcomes and implications. Trans Am Ophthalmol Soc 2002; 100: 61–66.
Harris GJ, Perez N . Anchored flaps in post-Mohs reconstruction of the lower eyelid, cheek, and lateral canthus: avoiding eyelid distortion. Ophthalmic Plast Reconstr Surg 2003; 19: 5–13.
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Hsuan, J., Selva, D. Early division of a modified Cutler–Beard flap with a free tarsal graft. Eye 18, 714–717 (2004). https://doi.org/10.1038/sj.eye.6701321
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DOI: https://doi.org/10.1038/sj.eye.6701321
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