title: Rotational Flap Repair of Full Thickness Eyelid Defects without a Posterior Lamellar Graft or Flap.
abstract: BACKGROUND
  To determine the safety and effectiveness of full thickness eyelid reconstructions using a semicircular rotational flap without reconstructing the posterior lamella.
  
  
  METHODS
  The charts of all patients undergoing semicircular flap closure of full thickness eyelid defects by one surgeon (JDP) at the Cole Eye Institute between March 2000 and October 2012 were reviewed. Charts were reviewed for patient demographic information, as well as for the size of the defect, the type of flap used, length of follow-up and complications.
  
  
  RESULTS
  Fifty eyelids of 50 patients underwent a semicircular flap repair without posterior lamellar reconstruction during the study period, and 41 charts were available for review. Average patient age was 74 years (range, 40-92 years). Average follow-up was 9.8 months (range, 1-84 months). Average defect size was 19.1 mm (range, 14-30 mm, SD 4.6). Complications included pyogenic granuloma (10 patients, 24.4%), exposure keratopathy (7 patients, 17.1%) lagophthalmos (5 patients, 12.2%), ectropion (6 patients, 14.6%), lateral canthal dystopia (2 cases, 4.9%), eyelid notch (2 cases, 4.9%) and trichiasis (4 cases, 9.8%). Two patients underwent subsequent tarsorrhaphy and one patient underwent ectropion repair. There were no cases of wound dehiscence, diplopia or fornix inadequacy, and the recruited aspect of the eyelid healed well in each case. No case required reconstruction of the eyelid margin or fornix.
  
  
  CONCLUSIONS
  Semicircular flap repair of full thickness eyelid defects without flap or graft repair of the posterior lamella results in an adequate fornix and a low rate of secondary surgery.
authors.affiliation: a Oculofacial Plastic Surgery Section, Cole Eye Institute Cleveland Clinic Foundation , Cleveland , Ohio , USA .
authors.forename: Stephen A
authors.initials: SA
authors.lastname: McNutt
authors.affiliation: a Oculofacial Plastic Surgery Section, Cole Eye Institute Cleveland Clinic Foundation , Cleveland , Ohio , USA .
authors.forename: Adam C
authors.initials: AC
authors.lastname: Weber
authors.affiliation: a Oculofacial Plastic Surgery Section, Cole Eye Institute Cleveland Clinic Foundation , Cleveland , Ohio , USA .
authors.forename: Bryan R
authors.initials: BR
authors.lastname: Costin
authors.affiliation: b Division of Ophthalmology , NorthShore University Health System , Skokie , Illinois , USA , and.
authors.forename: Milap P
authors.initials: MP
authors.lastname: Mehta
authors.affiliation: c Lansing Ophthalmology , East Lansing , Michigan , USA.
authors.forename: Craig D
authors.initials: CD
authors.lastname: Lewis
authors.affiliation: a Oculofacial Plastic Surgery Section, Cole Eye Institute Cleveland Clinic Foundation , Cleveland , Ohio , USA .
authors.forename: Julian D
authors.initials: JD
authors.lastname: Perry
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005141:Eyelid Diseases / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013524:Surgical Flaps; D055815:Young Adult
keywords: Eyelid; flap; repair; rotational