Eyelid Repair Procedures

下眼瞼重建手術

Small defect ( < 33%)
=> 外眥切開術(canthotomy)後，再直接縫合
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Moderate defect (33~50%)
=> semicircular rotation (可至50% defect）

Large defect ( > 50%)

* Hughes procedure (tarsoconjunctval flap from upper eyelid + skin graft) 最為理想
=> 若skin graft由它處取得，則叫modified Hughes procedure
=> modified Hughes procedure 需要蓋住pupil數週，屬Sharing-lid，應避免用於7歲以下小朋友，怕造成amblyopia

其它可修補更大範圍lid defect的procedre
* Cutler-Beard procedure (Full-thickness lower eyelid advancement)
* Tenzel semicircular rotation
=> 上兩種容易有round canthus的結果，應該不若Hughes procedure理想。

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上瞼修補比下瞼修補更複雜，更難！

large upper eyelid defect：Cutler-Beard procedure