Title : Surgical correction and outcome of postburn contracture of eyelid
Abstract:
Background: Postburn contracture of eyelids may produce significant ocular morbidity, especially of the upper lid. Marked Lagophthalmos leads to exposure keratopathy followed by loss of vision. Purpose of the study is to evaluate how this kind of eyelid deformity can be corrected to save vision.
Materials and methods: A total forty two patients of post burn contracture (either homicidal or accidental) had been corrected in the period from 2010 to 2024. Almost all of the patients had mild to severe exposure keratopathy depending on severity of Lagophthalmos and presence of Bell’s phenomenon. Bilateral involvement was present in 18 (42.85%)patients. Age range was 5-45 years. Among them 10(23.8%) were male and 32(76.19%) were female. Skin was harvested from multiple donar sites to correct larger defect. After excising all the cicatricial tissues, skin graft was done. Medial and lateral canthi were reconstructed wherever necessary at the same time. Among the female patients 10(31.35 %) patients had maltreated epilepsy.
Result: Exposure keratopathy was resolved in all patients 6 weeks postoperatively. Revision surgery was needed in 3 patients having extensive tissue loss from primary insult.
Conclusion: Functional and asthetic correction of postburn contracture of eyelid is always challenging. Loss of vital structures of eyelid and severe cicatrisation are important determining factors. Successful outcome depends on thoughtful decision, careful planning and meticulous surgical procedure.
