Hemant Mehta
Gwynedd Hospital, UK
Title: Versatility of the innovative myo-tarsal flap for reconstruction of lower eyelid
Biography
Biography: Hemant Mehta
Abstract
The myotarsal (MT) flap devised by this author is obtained from the upper eyelid and consists of a tarsal strip of 2mm or 3mm from the upper edge of the tarsal plate with the levator and Müller muscles attached - both muscles carrying their blood supply for the viability of the flap. The flap has very little conjunctiva that carries hardly any direct blood supply for the viability of the flap, though it plays a crucial role in providing a smooth mucosal lining. The anterior surface of the flap is formed by the levator, and the front surface of the 3-mm tarsal strip. The inferior border formed by the tarsal strip is free like its medial, and lateral borders. The horizontal width of the flap is adjusted to the requirement of its ultimate use. The flap is very versatile, multipurpose, and effective. With the same basic technique of acquiring it, the flap as a common denominator can be used for three different operations: (i) myogenic ptosis correction (ii) correction of retraction of the upper lid, and (iii) full thickness reconstruction of shallow as well as deep defects of 25% to nearly the full horizontal extent of the lower eyelid. The anterior lamina is formed with a full thickness skin graft (FTSG) secured with the author’s quilting technique. The flap is severed in a week without jeopardizing its own viability and that of the overlaid FTSG. The presentation will be amply illustrated.