Journal of Shanghai Jiao Tong University (Medical Science) >

2021 , Vol. 41 >Issue 2: 273 - 276

DOI: https://doi.org/10.3969/j.issn.1674-8115.2021.02.024

Brief original article

Evaluation of ocular surface following lip mucosa graft for palpebral margin defect

  • Xu-sheng WU ,
  • Yue WU ,
  • Chun-yi SHAO ,
  • Jin LI
Expand
  • Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China

Received date: 2020-06-17

  Online published: 2021-02-28

Supported by

National Key R&D Program of China(2018YFC1106100);National Natural Science Foundation of China(81870688);Natural Science Foundation of Shanghai(19441900800);Shanghai Pujiang Program(18PJD025);Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support(20191914)

Fold

Abstract

Objective

·To analyze the condition of ocular surface and tear film after reconstruction of palpebral margin with lip mucosa graft.

Methods

·Fifteen patients with palpebral margin defect who were treated in the Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from November 2017 to December 2019 were selected. All patients underwent the lip mucosa graft for palpebral margin reconstruction. A series of ocular surface examination, some ophthalmological physical examination and a questionnaire were prepared for each patient 6?8 weeks after surgery. The ocular surface examination was constituted of tear meniscus height (TMH), tear break-up time (BUT) and Schirmer test. The ophthalmological physical examination included affected palpebral fissure height (PFH) and levator function (LF). Finally, Ocular Surface Disease Index (OSDI) was used as a questionnaire.

Results

·There was no significant difference in TMH between fellow eyes and operated eyes [(0.24±0.07) mm vs (0.23±0.11) mm, P=0.316]. There was no significant difference in BUT between fellow eyes and operated eyes [(10.75±2.31) s vs (7.75±2.05) s, P=0.065]. There was no significant difference in the result of Schirmer text between fellow eyes and operated eyes [(10.20±1.96) mm/5 min vs (9.33±2.04) mm/5 min, P=0.376]. There was no significant difference in PFH between fellow eyes and operated eyes [(10.16±1.18) mm vs (10.11±2.11) mm, P=0.761]. There was no significant difference in LF between fellow eyes and operated eyes [(9.59±0.93) mm vs (9.03±1.02) mm, P=0.552]. The score of OSDI was 26.44±3.88 in average.

Conclusion

·The lip mucosa graft for treating palpebral margin defects gives a satisfactory result in tear film stability and binocular symmetry. Patients may have dry eyes according to the score of OSDI 6?8 weeks after surgery.

Key words： palpebral margin defect; lip mucosa graft; palpebral margin reconstruction; ocular surface

Cite this article

Xu-sheng WU , Yue WU , Chun-yi SHAO , Jin LI . Evaluation of ocular surface following lip mucosa graft for palpebral margin defect[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2021 , 41(2) : 273 -276 . DOI: 10.3969/j.issn.1674-8115.2021.02.024

References

1 Holbach LM. Diseases of the eyelid-conjunctival complex and corneal complications of lid disease[J]. Curr Opin Ophthalmol, 1995, 6(4): 39-43.
2 Kompella VB, Sangwan VS, Bansal AK, et al. Ophthalmic complications and management of Stevens-Johnson syndrome at a tertiary eye care centre in south India[J]. Indian J Ophthalmol, 2002, 50(4): 283-286.
3 Cher I. Blink-related microtrauma: when the ocular surface harms itself[J]. Clin Exp Ophthalmol, 2003, 31(3): 183-190.
4 Pullum K, Buckley R. Therapeutic and ocular surface indications for scleral contact lenses[J]. Ocular Surf, 2007, 5(1): 40-49.
5 Tougeron-Brousseau B, Delcampe A, Gueudry J, et al. Vision-related function after scleral lens fitting in ocular complications of Stevens-Johnson syndrome and toxic epidermal necrolysis[J]. Am J Ophthalmol, 2009, 148(6): 852-859.e2.
6 Sindt CW, Longmuir RA. Contact lens strategies for the patient with dry eye[J]. Ocular Surf, 2007, 5(4): 294-307.
7 Kheirkhah A, Blanco G, Casas V, et al. Surgical strategies for fornix reconstruction based on symblepharon severity[J]. Am J Ophthalmol, 2008, 146(2): 266-275.e4.
8 Siegel RJ. Palatal grafts for eyelid reconstruction[J]. Plast Reconstr Surg, 1985, 76(3): 411-414.
9 Leone CR. Mucous membrane grafting for cicatricial entropion[J]. Ophthalmic Surg, 1974, 5(2): 24-28.
10 McCord CD, Chen WP. Tarsal polishing and mucous membrane grafting for cicatricial entropion, trichiasis and epidermalization[J]. Ophthalmic Surg, 1983, 14(12): 1021-1025.
11 Whitehouse GM, Francis IC. Eyelid reconstruction using a monopedicle flap and buccal mucosa: report of 15 cases[J]. Aust N Z J Ophthalmol, 1988, 16(4): 295-301.
12 Shore JW, Foster CS, Westfall CT, et al. Results of buccal mucosal grafting for patients with medically controlled ocular cicatricial pemphigoid[J]. Ophthalmology, 1992, 99(3): 383-395.
13 Karesh JW, Putterman AM. Reconstruction of the partially contracted ocular socket or fornix[J]. Arch Ophthalmol, 1988, 106(4): 552-556.
14 Klein M, Menneking H, Bier J. Reconstruction of the contracted ocular socket with free full-thickness mucosa graft[J]. Int J Oral Maxillofac Surg, 2000, 29(2): 96-98.
15 Miyamoto J, Nakajima T, Nagasao T, et al. Full-thickness reconstruction of the eyelid with rotation flap based on orbicularis oculi muscle and palatal mucosal graft: long-term results in 12 cases[J]. J Plast Reconstr Aesthetic Surg, 2009, 62(11): 1389-1394.
16 Larsen SD, Heegaard S, Toft PB. Histological and clinical evaluation of the hard palate mucous membrane graft for treatment of lower eyelid retraction[J]. Acta Ophthalmol, 2017, 95(3): 295-298.
17 Fu Y, Liu J, Tseng SC. Oral mucosal graft to correct lid margin pathologic features in cicatricial ocular surface diseases[J]. Am J Ophthalmol, 2011, 152(4): 600-608. e1.
18 Mizuno Y, Yamada M, Miyake Y, et al. Association between clinical diagnostic tests and health-related quality of life surveys in patients with dry eye syndrome[J]. Jpn J Ophthalmol, 2010, 54(4): 259-265.
19 Schiffman RM, Christianson MD, Jacobsen G, et al. Reliability and validity of the ocular surface disease index[J]. Arch Ophthalmol, 2000, 118(5): 615-621.
20 McVeigh KA, Caesar R. Upper eyelid reconstruction using a blepharoplasty flap[J]. Ophthalmic Plast Reconstr Surg, 2017, 33(2): 147-149.
21 Jordan DR, Tse DT, Anderson RL, et al. Irradiated homologous tarsal plate banking. Part II. Human data [J]. Ophthalmic Plast Reconstr Surg, 1990, 6(3): 168-176.
22 Carroll RP. Entropion following the cutler-beard procedure[J]. Ophthalmology, 1983, 90(9): 1052-1055.
23 Yaqub A, Leatherbarrow B. The use of autogenous auricular cartilage in the management of upper eyelid entropion[J]. Eye, 1997, 11(6): 801-805.
24 Scuderi N, Ribuffo D, Chiummariello S. Total and subtotal upper eyelid reconstruction with the nasal chondromucosal flap: a 10-year experience[J]. Plast Reconstr Surg, 2005, 115(5): 1259-1265.
25 Holloman EL, Carter KD. Modification of the cutler-beard procedure using donor Achilles tendon for upper eyelid reconstruction[J]. Ophthalmic Plast Reconstr Surg, 2005, 21(4): 267-270.
26 Vaca EE, Surek C, Klosowiak J, et al. Neurotized free platysma flap for functional eyelid reconstruction: a cadaveric study of anatomical feasibility[J]. Plast Reconstr Surg, 2020, 145(4): 1049-1057.
Options
Outlines

/

〈 〉