Operative treatment for segmental eyelid vitiligo.

PURPOSE: The purpose of this article is to describe a safer method of removing the epithelium from the eyelid in preparation for melanocyte transplantation in treating segmental eyelid vitiligo.

METHODS

The Erbium yttrium-aluminum-garnet (YAG) laser was used for ablation of the epithelium on the nonpigmented skin of the eyelid. Subsequently, an epithelial skin graft containing melanocytes was applied to the affected area. An occlusive dressing was applied for 2 days.

RESULTS

The skin graft was found to be viable on removal of the dressing, and pigment was evident within the first week. No scarring developed, and an outstanding result was evident within a few weeks and has persisted.

CONCLUSIONS

Use of the Erbium YAG laser enabled us to perform the procedure safely in less than half an hour. The procedure was performed in an outpatient setting, using topical and local anesthesia. Previously, we were unwilling to offer treatment for depigmentation of the eyelid. This case demonstrates a safe method for treatment of eyelid vitiligo that can be performed by a surgeon experienced in use of the laser and epithelial grafting.