Orbit (Amsterdam, Netherlands) · 2026
Ocular surface outcomes after upper-eyelid-sparing management of large lower-eyelid tumor defects.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Edgren Adrianna, Nääv Ottosson Jens, Sheikh Rafi, Berggren Johanna, Malmsjö Malin, Bohman Elin
Аннотация
PURPOSE: To evaluate long-term ocular surface outcomes after upper-eyelid-sparing management of large lower-eyelid defects.
METHODS: Twelve patients with large lower-eyelid defects after tumor excision were managed without surgical involvement of the upper eyelid using either laissez-faire (secondary intention, n = 11) healing or primary closure under tension (n = 1). The operated eye was compared with the contralateral, non-operated eye. Assessments included the Dry Eye Questionnaire-5 (DEQ-5), margin- reflex distance (MRD) 1 and 2, tear break-up time (TBUT), tear meniscus height (TMH), ocular staining score (OSS), and infrared meibography.
RESULTS: No significant differences in TBUT or TMH were observed between operated and contralateral eyes, suggesting preserved tear film stability and tear volume despite lower-eyelid gland loss. Lower-eyelid meibography demonstrated a significant reduction in meibomian gland area in operated eyes, reflecting gland excision during tumor removal. Operated eyes showed significantly higher MRD2, DEQ-5 scores and OSSs, indicating greater exposure, subjective dry-eye symptoms, and ocular surface involvement.
CONCLUSION: Upper-eyelid-sparing management of large lower-eyelid defects preserves tear film stability on long-term follow-up but is associated with increased dry-eye symptoms and ocular surface staining. Thus, preservation of the upper eyelid and its meibomian glands appears sufficient to maintain functional tear film integrity despite substantial lower-eyelid gland loss, providing guidance for surgical decision-making to minimize postoperative ocular surface morbidity.
METHODS: Twelve patients with large lower-eyelid defects after tumor excision were managed without surgical involvement of the upper eyelid using either laissez-faire (secondary intention, n = 11) healing or primary closure under tension (n = 1). The operated eye was compared with the contralateral, non-operated eye. Assessments included the Dry Eye Questionnaire-5 (DEQ-5), margin- reflex distance (MRD) 1 and 2, tear break-up time (TBUT), tear meniscus height (TMH), ocular staining score (OSS), and infrared meibography.
RESULTS: No significant differences in TBUT or TMH were observed between operated and contralateral eyes, suggesting preserved tear film stability and tear volume despite lower-eyelid gland loss. Lower-eyelid meibography demonstrated a significant reduction in meibomian gland area in operated eyes, reflecting gland excision during tumor removal. Operated eyes showed significantly higher MRD2, DEQ-5 scores and OSSs, indicating greater exposure, subjective dry-eye symptoms, and ocular surface involvement.
CONCLUSION: Upper-eyelid-sparing management of large lower-eyelid defects preserves tear film stability on long-term follow-up but is associated with increased dry-eye symptoms and ocular surface staining. Thus, preservation of the upper eyelid and its meibomian glands appears sufficient to maintain functional tear film integrity despite substantial lower-eyelid gland loss, providing guidance for surgical decision-making to minimize postoperative ocular surface morbidity.