Experience in correcting postoperative defects of the eyelids and surrounding facial area

Objective. To develop a methodology for plastic closure of large defects of the eyelids and surrounding facial area, including after radical organ-sparing treatment of malignant tumors of the eye adnexa. Materials and methods. To improve the results of surgical treatment of patients with malignant tumors of the eye adnexa, existing methods for eliminating postoperative defects were modified using original approaches in plastic surgery. The aesthetic and functional results of the reconstructive and restorative stage of surgical treatment were evaluated using a scoring scale developed by us. Results. The study included 580 patients who underwent surgical treatment at the Central Clinical Hospital of the Ministry of Health of the Russian Federation and the Clinic of Bashkir State Medical University in 2008–2023. The developed methods of plastic closure of the eyelid defect and the surrounding area of the face were free from the disadvantages of rotation skin-fat flaps, such as decreased visual acuity, eyelid inversion and eversion, limited mobility of the eyeball, coloboma, ptosis, flap folding, but had better aesthetics of the transferred flap, a lower frequency of donor wound edge divergence (p<0.001), flap edge necrosis (p=0.001), lacrimation (p<0.001), statistically significantly fewer negative scores for reconstruction results (p<0.001), and provided a comparable amount of plastic material sufficient to close the defect in 99% of cases. Conclusion. The developed methods of radical surgical treatment of locally advanced and recurrent malignant tumors of the adnexa of the eye allow preserving vision in 98.6% of cases and functional aesthetics in 65.7% of cases.
Keywords: adnexa of the eye, malignant tumor, radical treatment, postoperative defect, plastic surgery, aesthetic result
Conflict of interest. The authors have no conflicts of interest.
Funding. This study received no funding.