Abstract: Bioengineered materials are used as a substitute in many fields of medicine, especially in plastic surgery and in burns. In ophthalmic plastic surgery they can be used for covering large tissue defects or as a tarsal plate substitute, in cases when it is not possible to use conventional surgical techniques. We have searched PubMed and Web of Science scientific databases. We can generally categorize skin substitutes by the type of tissue used—we distinguish autografts, allografts, and xenografts. There are also completely synthetic substitutes. The aim of our article was to summarize the current state of knowledge and to sum up all the clinical applications of bioengineered materials in the periocular region. There are only a few scientific articles about this topic and lack of prospective randomized studies aimed on use of bioengineered materials in periocular region. Nevertheless, there are many articles describing successful case reports or case reports series. According to literature, bioengineered materials are the most commonly used in big traumas or large surgical defects, especially in oculoplastic tumour surgery. Bioengineered dermal substitutes are not frequently used in the periocular region. Dermal substitutes are useful, when it is not possible to close the defect with any other conventional surgical technique.
Background: Using a randomized controlled trial (RCT), to assess the efficacy of the folded technique of self-adherent wrap to eyes after orbital tumour extirpation and compare it with the classic technique.
Methods: A single-centre, prospective, randomized, controlled study was conducted among 128 patients who underwent orbital tumour extirpation in this study. The folded and classic techniques of applying self-adherent wraps were randomly allocated to patients (1:1). The primary endpoint was the interface pressure on the affected eye. Secondary efficacy endpoints were the interface pressure above and below the ear of the affected side, above the ear of the non-affected side, and discomfort scores. Postoperative complications were observed for 24 hours.
Results: The interface pressure with the folded technique on the affected eye was neither inferior nor superior to the classic technique (1.33±0.07 vs. 1.41±0.09 mmHg, P=0.480). Most importantly, the pressure at three other points outside of the affected eye, including above and below the ear of the affected side, and above the ear of the non-affected side, were significantly higher when using the classic technique than when using the folded technique (P=0.041, 0.019, and 0.047, respectively). Discomfort scores were higher in the classic technique group than in the folded technique group (2.93±0.30 vs.1.52±0.19, P≤0.001).
Conclusions: Findings demonstrated the advantages of using folded technique to apply self-adherent wrap for wounds after orbital tumour extirpation with lower interface pressure outside of the affected eye and patient discomfort scores, without influencing pressure on the affected eye comparing with the classic technique.
Abstract: Eyelid surgery is widely and extensively used in facial plastic and reconstructive surgeries. There are many categories of eyelid surgeries, the most common of which include blepharoplasty, ptosis surgery, and eyelid reconstruction. In many cases, these procedures are combined, and there are many different techniques for each type of operation. Upper eyelid blepharoplasty usually includes the excision of skin, preseptal orbicularis oculi muscle, and orbital fat. Common methods of lower eyelid blepharoplasty are the skin-muscle flap, the skin flap, and the transconjunctival. Ptosis surgery is mainly divided into three types: transcutaneous, transconjunctival, and sling surgery. Surgeons often used the Hughes or Cutler-Beard Bridge Flaps in eyelid reconstruction. Different types and methods of surgery have their own advantages and disadvantages, and postoperative complications may occur. Therefore, postoperative complications of eyelid surgeries, such as dry eye symptoms, should be taken into serious consideration. Relevant literature involving these complaints can be found in PubMed by searching the terms “dry eye”, “eyelid”, “surgery”, and other related keywords. Moreover, various ocular surface and tear film alterations may be detected using the Ocular Surface Disease Index (OSDI), tear film breakup time, Schirmer test, fluorescein staining, and lissamine green staining after various eyelid surgeries. As dry eye disease is prevalent in the general population, it is more urgent to figure out what we can learn from these complaints. Further exploration in this field may help surgeons to choose a better surgical method and give an accurate evaluation of the postoperative effect.
