A. Kim, M. Kataev, M. Zakharova, F. Khulamkhanova, N. Usacheva
Moscow Helmholtz Eye Research Institute, Ocular Trauma Department, Moscow, Russian Federation
Introduction
"In toto" blepharoplasty method is actual in cases of ablepharia and safe eye globe. We present the case of traumatic ablepharia of both eyes and the results of eyelids reconstruction.
Case
A 32 y.o. patient, being under the drug intoxication, has cut his eyelids off by himself with a shaving blade. First aid was administered at the local hospital and consisted of eye globe bio capping and wounds stitching. 6 days later patient was hospitalized to Moscow Helmholtz Eye Research Institute's Trauma Department. Both sides upper and lower eyelids ablepharia was detected, but the eye globes were safe due to bio capping and a large amount of ointment. Lagophthalmos was about 15 mm. So we decided to perform a blepharoplasty "in toto" as the first reconstruction stage. The operation consisted in bio capping removal, conjunctiva rests suturing, upper and lower muscular layers mobilization and it's supramucosal suturing, brachion skin flaps dissection, supra muscular skin flaps fixation to the skin wounds edges, compressing bandage application. Postoperatively we observed complete engraftment and in 6 months the second reconstruction stage - 4 mucosa flaps transplantation for fornices replacement, was performed. We plan the eye lashes transplantation as the 3rd reconstruction stage to achieve better cosmetic result and to form eye lids matrix.
Discussion and conclusion
We can achieve complete engraftment due to mucosa and muscular layer reconstruction. The method of total eye lids repair - "in toto" blepharoplasty can be used in cases of ablepharia as it helps to preserve eye globe, achieve good functional and cosmetic result and enhance patient's quality of life in future.