title: Operative treatment of large periocular xanthelasma.
abstract: OBJECTIVE
  To present our experience in operative treatment of large periocular xanthelasma.
  
  
  METHODS
  Sixty-three patients with large periocular xanthelasma were operatively treated in our department. Ipsilateral and/or contralateral lid skin grafts harvested by blepharoplasty, alone or in combination with local flaps, were used. Forty patients (64%) had enough skin to graft the defect after primary xanthelasma removal. In 10 patients, additional local flaps were used: modified rhomboid flap in six patients, local advancement flap in two, and bi-lobed flap in two patients. In three patients (5%), a sequential approach was applied since xanthelasma were too large to be completely removed in a single-step excision. No serious complications were shown.
  
  
  RESULTS
  Patients were followed from 6 months to 8 years. Five patients (8%) returned with recurrences 3-8 years after primary excision.
  
  
  CONCLUSIONS
  In lack of the setting for xanthelasma laser treatment, operative approach of a single-step or sequential excision using lid skin graft combined with local flaps proved its value for large periocular xanthelasma.
authors.affiliation: Department of Ophthalmology, General Hospital, Sveti Duh, Zagreb, Croatia. belabjer@obsd.hr
authors.forename: Biljana Kuzmanović
authors.initials: BK
authors.lastname: Elabjer
authors.forename: Mladen
authors.initials: M
authors.lastname: Busić
authors.forename: Sandra
authors.initials: S
authors.lastname: Sekelj
authors.forename: Edita Kondza
authors.initials: EK
authors.lastname: Krstonijević
mesh_terms: D000328:Adult; D000368:Aged; D019882:Blepharoplasty; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014973:Xanthomatosis / Q000601:surgery*