Restoration of function following traumatic superior eyelid avulsion in a horse treated with advancement flap blepharoplasty (H-plasty) and subdermal hyaluronic acid filler.

This research article discusses a case where the function of a horse’s eyelid, which was severely damaged due to trauma, was successfully restored using an advanced eyelid surgical method and the injection of a unique filler substance.

Objective of the Research

The main objective of this research is to describe how the function of the superior eyelid in a horse could be restored after a traumatic injury that resulted in avulsion of about 75% of the left superior eyelid. It also aims to communicate the effectiveness of using an advancement flap blepharoplasty technique (H-plasty), alongside subdermal hyaluronic acid filler injection to improve the healing process and restore normal eyelid function.

Research Methods

• The subject of the research was a 21-year-old American Paint Horse stallion, which had been attacked by a fellow stallion. This resulted in various injuries, including severe damage to the left superior eyelid.
• Understanding sedation and locoregional anesthesia, the researchers debrided the superior eyelid wound and performed an advancement flap blepharoplasty (H-plasty) and temporary tarsorrhaphy – a procedure where the eyelids are partially sewn together to protect the eye.
• The surgical site showed routine healing over the subsequent weeks, though the condition called lagophthalmos (incomplete eyelid closure) persisted.
• Two and four weeks post-operatively, 2.4% cross-linked hyaluronic acid was injected subdermally into the superior eyelid as an attempt to enhance corneal coverage.

Results and Findings

• Eight weeks post-operatively, the horse had fully regained the ability to blink with the left superior eyelid, and the cosmetic outcome was found to be good.
• It was concluded that injecting subdermal hyaluronic acid filler following eyelid injuries or surgeries that result in lagophthalmos was able to support the improvement of corneal coverage by the eyelids, leading to the maintenance of a clear and comfortable eye.

Conclusions and Implications

• The findings of this research show promising results in promoting the healing process and restoring normal eyelid function after severe trauma.
• This innovative approach could be applied in veterinary clinical practice, particularly in the surgical management of eyelid injuries in horses and potentially other large animals.
• Further study can be conducted to observe long-term results, and test the different doses and frequencies of subdermal hyaluronic acid filler injections.