Vertical Lid Split to Aid Excision and Reconstruction of Conjunctival Tumors Involving the Fornices

Abstract

Purpose: To describe how a vertical lid split helps excision and reconstruction of conjunctival tumors.

Methods: All patients with a limited view of conjunctival tumors involving the fornices underwent a vertical lid split procedure to improve access during resection and reconstruction.

Results: There were 11 cases where vertical lid splits were performed to assist excision and reconstruction of conjunctival tumors on patients between 2015 and 2019. There were 4 male and 7 female patients, 50-85 years of age, mean age 67.2 years. Four patients had invasive malignant melanoma, 2 melanoma in situ, 3 invasive squamous cell carcinoma, and 2 squamous cell carcinoma in situ. The authors have had no local reoccurrences in 9 patients (follow-up 8-54 months, mean 18 months). One patient's deep margins were involved and proceeded to exenteration, and 1 patient died from liver metastases.

Conclusions: A vertical lid split incision of either or both eyelids, well away from the visible tumor edge splays the lid open allowing the whole conjunctival surface to be stretched out and viewed as a single flat sheet. This aids excision and reconstruction of the tumor, potentially reducing the risk of seeding and simplifying the reconstruction.