Eyelid tumours are common in clinical practice but are less common in exams as they usually proceed to surgery quickly after diagnosis. Eyelid tumour cases are commonly presented as data stations in clinical examinations.
The general principles of managing an eyelid tumour are to:
This is relevant for determining:
These tests will determine whether orbital or further imaging modalities will be required.
Liver function test for malignant melanoma
Treatment plans need to consider the patient as a whole. Consider the following factors which influence choice of treatment (“TAFE”).
T umour Features
Older patients or those with short life expectancy may be suitable for less invasive procedures with a higher recurrence risk to maximise their quality of life
F itness of patient for surgery
Tolerance of major lid reconstruction
(Other) E ye
Complex reconstructions may require occlusion of vision in the affected eye for prolonged periods which is unsuitable for patients with poor contralateral vision.
(< 1 / 3)
UPPER LID AND LOWER LID
(< 1 / 2)
UPPER LID AND LOWER LID
Direct closure (if very lax lids)
Lateral Canthotomy or Periosteal flap + skin advancement flap
Free Tarso-conjunctival graft + skin advancement flap
(> 1 / 2)
1. Cutler-Beard (Bridging flap)
Tarsoconjunctival Grafts + Mustarde's lid switch flap
Posterior Lamellae Flap
1. Hughes Procedure + Ant lamellar graft / advancement flap
Hewes Procedure + Anterior lamellar graft
Anterior Lamellae Flap
1. Mustarde cheek rotation + posterior mucosal graft
Upper lid myocutaneous transposition flap (Tripier)
Medial forehead flap
Lateral forehead transposition flap (Fricke)
Reconstruction Options for Upper or Lower Lid Full Thickness Defects, Depending on the Size of the Lesion
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Vitreoretinal Surgery Online
This open-source textbook provides step-by-step instructions for the full spectrum of vitreoretinal surgical procedures. An international collaboration from over 90 authors worldwide, this text is rich in high quality videos and illustrations.