14-year experience in eyelid burn surgery: A single-center retrospective cohort study
Tiffany E. Jeong*, Mario Alessandri Bonetti, Avril Betances, Guy Stofman, Francesco Egro
Department of Plastic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA
It is rare for burn traumas to directly involve the eye. However, loss of vision and other ocular defects are a concern with eyelid burn sequelae. Release and grafting are required for these cases. However, there is a paucity of studies on outcomes in eyelid burn surgery treatment. This study aims to describe the complication rates in burn eyelid reconstruction at a single center over 14 years.
We conducted a retrospective study to review outcomes of eyelid burns reconstruction between April 2009 and February 2023. Medical records were reviewed for: past medical history, type of injury, indication for surgery, procedure performed and complications.
14 patients and 25 eyelids had eyelid burn reconstruction from April 2009 until February 2023. These patients had 54 eyelid surgeries occurring 15.0±56.7months after burn injury, with a mean follow-up time of 13.7±17.1months. In 53.7%(n=29) of cases, the simultaneous reconstruction of upper and lower eyelids was necessary. The eyelid procedures performed included: full thickness skin graft (48.2%, n=26), flap (14.8%, n=8), skin substitute application (16.7%, n=9), split thickness skin graft (7.4%, n=4), canthoplasty (7.4%, n=4), and fractional lasering (1.8%, n=1). 26 eyelid surgeries included temporary tarsorrhaphy that remained in place for an average of 7.1±4.6 days. One case received permanent tarsorrhaphy (1.9%). The overall complication rate was 53.7% (n=29). The most common complication was ectropion/contracture (42.6, n=23). All 23 of these cases underwent more eyelid reconstruction. Other complications included: lagophthalmos (17.9%, n=10), visual disturbances (7.4%, n=4), eyelid infection (10.7%, n=4), total graft loss (3.7%, n=2), and partial graft loss (3.7%, n=2).
Full thickness skin graft remains the standard of care for patients with eyelid burns. However, there is a high incidence of ectropion that may require reoperation. Further studies examining the conditions of successful eyelid burn procedures may provide guidance on when patients may benefit from eyelid reconstruction.
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