Use of subdermal hyaluronic acid injections and a free labial mucocutaneous graft for the repair of feline eyelid agenesis

Free labial mucocutaneous graft for eyelid reconstruction in four dogs

PURPOSE

To describe a technique for eyelid margin reconstruction following large mass resection utilizing a free labial mucocutaneous graft.

METHODS

Four dogs (4 eyes) underwent en bloc eyelid mass excision under general anesthesia. Measurements were made of the mass followed by free labial mucocutaneous graft retrieval, resection of the mass, and then transplantation of retrieved region of labial mucocutaneous tissue into the resulting defect.

RESULTS

Three patients underwent eyelid margin reconstruction with a free labial mucocutaneous graft. One patient received a pedicle advancement graft combined with a free labial mucocutaneous graft. In all cases, a length of 120%-150% of the eyelid defect was retrieved from the oral labia. Postoperative follow-up ranged from 6 weeks to 4 months. All cases had superficial graft necrosis and depigmentation of the donor tissue with total healing time taking up to 8 weeks. All cases had an esthetic and functional reconstruction.

CONCLUSIONS

This technique allows reconstruction of the majority of the eyelid margin, greater than that which can be closed primarily. Due to tissue sloughing, the healing time can be extended but cosmetic outcomes are good. Eyelid reconstruction utilizing a free labial graft restored a mucocutaneous margin and recreated a functional eyelid, thus avoiding trichiasis or secondary keratitis.

[Subdermal hyaluronic acid injection treatment of an upper eyelid entropion in a rabbit]

Surgical correction is the typical treatment for an entropion. However, considerable anesthetic risk exists for a subset of patients, particularly rabbits and guinea pigs. In a high number of these cases, this represents the main reason for reluctance to treat an entropion. The following report describes the case of a 9-year-old rabbit with a superficial cornea defect and a mild entropion of the upper eyelid. Eversion of the eyelid from a mild entropion to a normal position was attained by the subdermal injection of a hyaluronic acid filler (Alayna SG 24 Distinct®, BSC Medical Devices GmbH, Munich, Germany) without necessitating general anesthesia or sedation. Following a period of 273 days, a relapse occurred which was subsequently successfully treated with a repeat injection. An entropion of the contralateral eye became evident during the follow-up period and was also effectively managed by a single subdermal filler injection. In the reported case, treatment with subdermal hyaluronic acid injection proved to be well tolerated and efficacious.