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Veterinary ophthalmology2020; 23(5); 899-904; doi: 10.1111/vop.12806

Use of a chronic soft tissue expansion device to facilitate blepharoplasty in a horse with lower-lid cicatricial ectropion with a 14-year follow-up.

Abstract: A 3-year-old Thoroughbred filly presented to a referral equine hospital for surgical correction of a severe cicatricial lateral lower eyelid ectropion OD, with secondary exposure keratitis. The severity of the ectropion deemed that conventional ectropion repairs would be unsuccessful. Therefore, a soft tissue expansion device was used to create sufficient local tissue for a rotational graft with tension-relieving horizontal incisions to be performed to facilitate closure and acceptable eyelid apposition. The keratitis had resolved by two months postoperatively. There were no long-term complications and only mild recurrence of the keratitis observed 14-years postoperatively.
© 2020 American College of Veterinary Ophthalmologists.
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Publication Date: 2020-07-20 PubMed ID: 32687627DOI: 10.1111/vop.12806Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research paper refers to a case study about the successful use of a novel surgical technique involving a soft tissue expansion device to repair a severe eyelid deformity (ectropion) in a young horse, with sustained results over a 14-year follow up period.

Case Description

  • The study focuses on a 3-year-old Thoroughbred filly that was brought to an equine hospital for the surgical correction of a severe cicatricial (scarred) lateral lower eyelid ectropion on the right eye (OD). This condition causes the eyelid to turn outwards, which exposed the cornea, leading to secondary keratitis (cornea inflammation).

The Nature of the Problem

  • The severity of the filly’s ectropion was such that conventional surgeries for the repair of ectropion were expected to fail. This predicted failure was because these approaches would not be able to provide the required additional tissue needed to correct the eyelid positioning effectively while avoiding undue tension on the surgical sites.

Surgery Method

  • To overcome this challenge, surgeons used a soft tissue expansion device – a balloon-like implement that can be inserted beneath the skin and gradually inflated to ‘expand’ the surrounding tissue over time. This process aimed to create enough local tissue to be used for a rotational graft to correct the mispositioned eyelid. This strategy also deployed tension-relieving horizontal incisions to reduce pressure on the surgical sites.

Postoperative Results

  • The keratitis condition was resolved two months after the procedure, indicating that the eyelid was sufficiently positioned to cover and safeguard the cornea. This protection is vital because it demonstrates that the surgical repair of the ectropion was successful.

Long-term Follow-up

  • Following a 14-year follow-up period, the study reported that there were no long-term complications associated with the procedure or the innovative surgical device. A mild recurrence of keratitis was noted, pointing to a possibility of slight lessening of the effective eyelid coverage over the cornea.

Conclusion

  • The article concludes by implying the potential of the soft tissue expansion device use as a novel treatment option for severe ectropion in horses, emphasizing that the procedure yielded sustained positive results over a long-term period.

Cite This Article

APA
Whittaker CJ, Reynolds BD, McCarthy PM, Taylor SF, Major D, Caruso KA, Smith J. (2020). Use of a chronic soft tissue expansion device to facilitate blepharoplasty in a horse with lower-lid cicatricial ectropion with a 14-year follow-up. Vet Ophthalmol, 23(5), 899-904. https://doi.org/10.1111/vop.12806

Publication

Veterinary ophthalmology
ISSN: 1463-5224
NlmUniqueID: 100887377
Country: England
Language: English
Volume: 23
Issue: 5
Pages: 899-904

Researcher Affiliations

Whittaker, Cameron J
  • Eye Clinic for Animals, Artarmon, NSW, Australia.
Reynolds, Benjamin D
  • Eye Clinic for Animals, Artarmon, NSW, Australia.
McCarthy, Paul M
  • Eye Clinic for Animals, Artarmon, NSW, Australia.
Taylor, Simon F
  • Sydney Adventist Hospital Clinical School, Faculty of Medicine and Health, The University of Sydney, Wahroonga, NSW, Australia.
Major, Derek
  • Agnes Banks Equine Clinic, Agnes Banks, NSW, Australia.
Caruso, Kelly A
  • Eye Clinic for Animals, Artarmon, NSW, Australia.
Smith, Jeffrey
  • Eye Clinic for Animals, Artarmon, NSW, Australia.

MeSH Terms

  • Animals
  • Blepharoplasty / veterinary
  • Ectropion / veterinary
  • Female
  • Follow-Up Studies
  • Horse Diseases / surgery
  • Horses
  • Surgical Flaps / veterinary
  • Tissue Expansion Devices / veterinary

References

This article includes 18 references
  1. Van der Woerdt A. Adnexal surgery in dogs and cats.. Vet Ophthalmol 2004;7:284-290.
  2. Henriksen ML, Plummer CE, Brooks DE. Modified Kuhnt-Szymanowski surgical procedure for secondary cicatricial ectropion in a horse.. Vet Ophthalmol 2013;16(4):276-281.
  3. Mowat F, Bartoe JT. Adnexal surgery.. In: Auer JA, Stick JA, eds. Equine Surgery. 4th edn. St. Louis, MS: Saunders Elsevier, 2012:744-770.
  4. Fang L, Zhou C, Yang M. “Expansion in situ” concept as a new technique for expanding skin and soft tissue.. Exp Ther Med 2013;6:1295-1299.
  5. Wilhelmi BJ, Blackwell SJ, Mancoll JS, Phillips LG. Creep vs. stretch: a review of the viscoelastic properties of skin.. Ann Plas Surg 1998;41(2):215-219.
  6. Austad ED, Rose GL. A self-inflating tissue expander.. Plast Reconstr Surg 1982;70(5):588-592.
  7. Ascherman JA, Zeidler K, Morrison KA. Carbon dioxide-based versus saline tissue expansion for breast reconstruction.. Plast Reconstr Surg 2016;138(6):1161-1170.
    doi: 10.1097/prs.0000000000002784google scholar: lookup
  8. Chandawarkar RY, Lawrence Cervino A, Pennington GA. Intraoperative acute tissue expansion revisited: a valuable tool for challenging skin defects.. Dermatol Surg 2003;29(8):834-838.
  9. Chummun S, Addison P, Stewart KJ. The osmotic tissue expander: a 5-year experience.. J Plast Reconstr Surg 2010;63:2128-2132.
  10. Kajikawa A, Ueda K, Katsuragi Y, Hirose T, Asai E. Three-step orbitofacial reconstruction after extended total maxillectomy using free RAM flap and expanded cervicofacial flap with cartilage grafts.. J Plast Reconstr Surg 2010;63:1608-1614.
  11. Victor WH, Hurwitz JJ. Cicatricial ectropion following blepharoplasty: treatment by tissue expansion.. Can J Ophthalmol 1984;19:317-319.
  12. De Lorenzi M, Swan MC, Easter C, Chanoit GPA. Outcome of reconstruction of cutaneous limb defects in dogs using hygroscopic “self-inflating” tissue expanders.. J Small Anim Pract 2018;59:98-105.
  13. Keller WG, Aron DN, Rakich PM, Crowe DT, Marks MA. Rapid tissue expansion for the development of rotational skin flaps in the distal portion of the hindlimb of dogs: an experimental study.. Vet Surg 1994;23:31-39.
  14. Madison JB, Donawick WJ, Johnston DE, Orsini RA. The use of skin expansion to repair cosmetic defects in animals.. Vet Surg 1989;18:15-21.
  15. Beard WL, Wilkie DA. Partial orbital rim resection, mesh skin expansion, and second intention healing combined with enucleation or exenteration for extensive periocular tumours in horses.. Vet Ophthalmol 2002;5:23-28.
  16. Plummer CE, Smith S, Andrew SE. Combined keratectomy, strontium-90 irradiation and permanent bulbar conjunctival grafts for corneolimbal squamous cell carcinoma in horses (1990-2002): 38 horses.. Vet Ophthalmol 2007;10:37-42.
  17. Colitz CH, Barden CA, Lu P. Basic Science: Ultraviolet irradiation u-regulates telomerase transcription and activity in lens epithelial cells.. Vet Ophthalmol 2006;9:379-385.
  18. Wagh MS, Dixit V. Tissue expansion: concepts, techniques and unfavourable results.. Indian J Plast Surg 2013;46(2):333-348.

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