Repair of eyelid posterior layer defect

The defect in the posterior layer of the eyelid refers to the defect of the tarsal plate and the palpebral conjunctiva. The posterior layer of the eyelid needs to be reshaped before repairing, which is easy to repair. Treatment of diseases: congenital eyelid defects Indication Localized eyelid defect. Preoperative preparation Antibiotic eye drops were given in the conjunctival sac for several days before surgery. Surgical procedure Fascial conjunctival transitional valve repair 1. Trimming the wound to make it into a shape. A vertical incision is made backwards along both sides of the wound surface, and the posterior tarsal conjunctiva is cut, and the incision is appropriately extended to the conjunctiva. The orbicularis oculi muscle of the tarsal surface is separated, so that the palpebral conjunctiva transition flap is presented. 2. Advance the conjunctival flap of the tarsal plate to the iliac crest, pay attention to the sacral margin, and suture with the sacral margins on both sides of the iliac crest. Transpositional palpebral conjunctival flap repair It is suitable for the upper part of the tarsal plate to be a full segment defect, and the defect wound width is not more than 1/3 long. 1. The creased wound is in the shape of a distance. At the posterior 1/2 of the adjacent normal tarsal tissue, the tarsal conjunctival flap is the same width as the defected wound. Separate the tarsal conjunctival flap. 2. The conjunctival flap of the tarsal plate was translocated to the iliac crest part of the defect wound, and the iliac crest was aligned with the iliac crest of the bilateral iliac crest, and the palpebral conjunctiva and conjunctival wound margin were sutured intermittently. Diaphragmatic flap repair The tongue-shaped iliac plate transition flap is used to repair the partial tarsal defect of the contralateral eyelid. Clinically, the upper lingual flap is used to repair the palpebral defect of the lower jaw because the upper sac is wider than the lower tarsal plate. 1. Trimming the sacral part of the sacral defect to make the wound shape. The two sides of the cleft lip are split into two layers. The gingival margin of the corresponding part of the upper jaw is also opened between the lips, so that the front and back are two layers. The posterior layer of the upper jaw corresponding to both sides of the defect of the lower jaw is perpendicularly cut off the conjunctiva of the tarsal plate and reaches the iliac crest. The epithelial tissue of the iliac crest site was removed, and the conjunctival transitional flap was formed into a tongue-shaped tarsal plate. 2. Move the flap of the tongue-shaped sacral plate downward and insert it into the defect of the lower jaw. The distal end of the tongue-shaped tarsal flap was sutured with the soft tissue of the lower jaw. The distal end of the tongue-shaped tarsal flap was sutured with the soft tissue of the lower jaw. The sacral flaps on both sides of the tongue-shaped sacral flap are buryed and sutured on both sides of the upper and lower iliac crests. Pay special attention to the alignment of the tarsal plate at the rim site. The anterior eyelid defect is repaired by a moving flap.