Analysis of cosmetic and functional outcomes of cutler-beard procedure used for large upper eyelid defects

• Author Details:   
• Apjit Kaur
• Ajay Kumar Arya
• MM Goel

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Background: Cutler-Beard is an established procedure for reconstruction of full thickness upper eyelid defects. This procedure involves the creation of an advancement flap from the lower lid that includes skin, orbicularis muscle and conjunctiva to fill the upper eyelid defect.
Aims and Objectives: The aim of this study is to analyse the cosmetic and functional outcomes of Cutler-Beard procedure used for large upper eyelid defects.
Methods: This is retrospective case series analysis of 74 patients who underwent Cutler Beard procedure for upper eyelid defects following excision of upper eyelid malignancy in department of ophthalmology, KGMU from Jan 2011 to July 2016. Data  analysis included age and gender of patients, size and location of tumour, intra-operative width of defect, histopathological report, post-operative TBUT, palpebral fissure height measurement (in mid-pupillary line in millimetres) and cosmetic satisfaction . Cosmetic satisfaction was a subjective criterion.
Results: Upper eyelid reconstruction was successful without complications in all patients. Mean follow up of patients was of 18.14 months (6 weeks – 36 months). 57 cases showed good cosmetic satisfaction, 17 fair while none were unsatisfied. 22 patients had initial foreign body sensation. Majority showed straightening of upper eyelid curvature. All patients had adequate eyelid closure.
Conclusions: Cutler-Beard procedure provides good functional relief with minimal cosmetic issue.

Keywords: Advancement flap, Palpebral fissure height, Cosmetic satisfaction