Application Of Modified Tarsorrhaphy After Eyelid Tumor Resection

Objective:To investigate the clinical effect of modified tarsorrhaphy after eyelid tumor resection.Methods:A retrospective series of case studies.From December 2013 to November 2019,the dermatology department of the second hospital of Jilin University applied tarsorrhaphy to repair the defect of eyelid after resection of tumor in 8 cases,of which 5 cases were treated with tarsorrhaphy alone,and 3 cases were treated with other methods(local flap transplantation,free skin graft)together.There were 5 males and 3 females.The age range is 9 years to 69 years old.There were 6 cases of basal cell carcinoma,1 case of eyelid divided nevus and 1 case of sebaceous nevus.The defect involved 5 cases of the left lower eyelid,1 case of the left upper eyelid,1 case of the upper and lower eyelid of the right eye,and 1 case of the upper and lower eyelid of the left eye.After tumor resection,all the defects involved the skin layer or the superficial layer of eyelid.The range of defect was 1.0cm×1.0cm to 5.5cm×6.5cm.The second stage operation was 21 days to 8 months after the first operation.The patients were followed up for 1 month to 12 months and high-definition photos were taken.The data of patients and follow-up photos were analyzed.To evaluate the blink function,ectropion or retraction of eyelid,continuity of palpebral margin,postoperative scar,size of palpebral fissure,vision abnormality,sensory abnormality,eye shape and comfort.Results:The operation cure rate of the patients was 100%,all the incisions reached grade A healing.The objective evaluation of the excellent rate is 85.7% and the patient satisfaction rate is 85.7%.After 1 month ?12 months of follow-up,there was no recurrence of the original eyelid skin tumor,and no conjunctival irritation was observed in the postoperative patients.The eyelid function was not affected,the eyelid morphology was good.The appearance of the eyelid was satisfactory to both doctors and patients.One patient had slight ectropion after operation,but the appearance of the blepharon was continuous and complete,and there was no discomfort such as dry eyes and tears.Conclusion:1.The modified tarsorrhaphy is suitable for the small area defect of eyelid with the longitudinal diameter less than 5mm-10 mm.It can avoid the separation of palpebral ball separation or ectropion palpebrarum caused by direct suture,and avoid the use of transfer flap,which will prevent the increase of additional incision,the deformity of “cat's ear”,the bloated flap and other complications.2.In the case of eyelid or perieyelid defect which needs to be repaired by transfer flap or skin flap,if the design is wrong during the operation and the estimated amount of repair tissue is insufficient,the tarsorrhaphy can be used to make up.Through the practice of opening eyes after operation,the purpose of expanding the skin at the palpebral margin is achieved,and the palpebral ball separation or ectropion palpebrarum caused by insufficient tissue of skin flap or flap or contracture after operation can be prevented.3.If the defect involves both the upper and lower eyelid margin,the eyelid ectropion caused by the free skin graft contracture of the upper and lower eyelids can be avoided by the eyelid margin adhesion operation with the upper and lower eyelids as a whole.4.On the basis of restoring the normal physiological function of the eyelid skin,taking into account the aesthetic characteristics,the operation can reconstruct the normal shape of the eyelid,especially the eyelid margin well.The method is simple and easy to use.There is no foreign body feeling in the eye,and it is not easy to damage the normal physiological structure of the eyelid and the eyelash follicle.The overall effect is good,and the patient's satisfaction is high.It is suitable for clinical application.