Reconstruction of Eyelid Posterior Lamella Using Deep Fascia: An Experimental Study in Rabbits

Öz

Eyelid reconstruction may be necessary after eyelid burns, trauma, or tumor resections. The limited availability of tarsoconjunctival tissue has led to the use of various grafts, including hard palate mucosa, lip mucosa, cartilage grafts, and acellular dermal matrix. This study aimed to evaluate the experimental use of deep fascia grafts in eyelid reconstruction, hypothesizing that they can provide adequate structural and physiological support when covered by conjunctival epithelium. An experimental study was conducted on 16 rabbits, divided into two groups: a graft group (n=8) and a control group (n=8). A 1x1 cm defect was created in the posterior lamella of the lower eyelid in all animals. The defect in the graft group was repaired with a deep fascia graft from the anterior thigh, while defects in the control group were left to secondary healing. Macroscopic outcomes included hematoma, eye irritation, conjunctivitis, and scleral show. Microscopic outcomes included inflammation, fibrosis, vascularization, conjunctival epithelialization, and goblet cell presence. Macroscopic changes were monitored for one month. Microscopic evaluations of harvested tissues were performed by a pathologist, and statistical analyses determined significance. In the graft group, no scleral show was observed, while it was evident in the control group. Microscopic examination revealed statistically significant differences in inflammation and vascularization between groups. The deep fascia graft demonstrated sufficient support, compatibility with conjunctival epithelium, and absence of ocular irritation. These results suggest that deep fascia may serve as a viable alternative for posterior lamella reconstruction.

Anahtar Kelimeler

• graft
• posterior lamella
• reconstructive surgery

Derin Fasya Kullanılarak Göz Kapağı Posterior Lamellasının Rekonstrüksiyonu: Tavşanlarda Deneysel Bir Çalışma

Öz

Göz kapağı rekonstrüksiyonu, yanıklar, travmalar veya tümör rezeksiyonları sonrasında gerekli olabilir. Tarsokonjonktival dokunun sınırlı bulunabilirliği, sert damak mukozası, dudak mukozası, kıkırdak greftleri ve aselüler dermal matriks gibi çeşitli greftlerin kullanımına yol açmıştır. Bu çalışma, derin fasya greftlerinin göz kapağı rekonstrüksiyonunda deneysel olarak kullanımını değerlendirmeyi ve konjonktival epitel ile kaplandığında yeterli yapısal ve fizyolojik desteği sağlayabileceği hipotezini test etmeyi amaçlamıştır. Çalışmada 16 tavşan kullanılarak deneysel bir model oluşturulmuş, hayvanlar greft grubu (n=8) ve kontrol grubu (n=8) olmak üzere ikiye ayrılmıştır. Tüm hayvanların alt göz kapağının posterior lamellasında 1x1 cm boyutunda defekt oluşturulmuştur. Greft grubundaki defektler, ön uyluk bölgesinden alınan derin fasya grefti ile onarılırken, kontrol grubundaki defektler sekonder iyileşmeye bırakılmıştır. Makroskopik sonuçlar arasında hematom, göz irritasyonu, konjonktivit ve skleral show değerlendirilmiştir. Mikroskopik değerlendirmeler ise inflamasyon, fibrozis, vaskülarizasyon, konjonktival epitelizasyon ve goblet hücre varlığı parametrelerini içermiştir. Makroskopik değişiklikler bir ay boyunca izlenmiş, histopatolojik değerlendirmeler patolog tarafından yapılmış ve istatistiksel analizlerle anlamlılık değerlendirilmiştir. Greft grubunda skleral show izlenmezken, kontrol grubunda belirgin şekilde gözlenmiştir. Mikroskopik incelemelerde inflamasyon ve vaskülarizasyon düzeylerinde gruplar arasında istatistiksel olarak anlamlı fark saptanmıştır. Derin fasya grefti yeterli yapısal destek sağlamış, konjonktival epitel ile uyumluluk göstermiş ve oküler irritasyona yol açmamıştır. Bu sonuçlar, derin fasyanın posterior lamella rekonstrüksiyonu için uygulanabilir bir alternatif olabileceğini göstermektedir.

Anahtar Kelimeler

• greft
• posterior lamella
• rekonstrüktif cerrahi

Kaynakça

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