Dr. HIRANMOYEE DAS

Abstract

Introduction – Large lesion in upper eyelid requiring full thickness repair is always challenging for optimal cosmetics & functional outcome. The aim of this video is to show important steps in surgical management of large upper eyelid defects with modified Cutler- Beard technique for excellent results.

Methods- Cutler-Beard technique, a classic two-staged procedure utilizing full-thickness vertical advancement bridge flap from the lower eyelid. Modifications we made in this technique are in stage I-

1.leaving the lower tarsus intact to prevent destabilization or ectropion of the donor site.

2.extending the ends of vertical incisions horizontally to provide sufficient tissue for stretch.

3. the division of the flap into anterior and posterior lamina & the careful re-attachment of Levator Palpebrae Superioris.

stage II- the differential division of lamina (conjunctiva longer than skin-muscle lamina), and construct the upper lid margin with conjunctiva to prevent entropion.