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A comprehensive evaluation of flap reconstruction in periocular repair: outcomes, complications, and future directions

Year: 2025

Type: article

Abstract: PURPOSE: To conduct a systematic evaluation of reconstructive techniques for the periocular area and eyelids, highlighting their functional and cosmetic outcomes, complications, and future advancements. METHOD: A systematic review was conducted following PRISMA guidelines. Searches were performed in PubMed, Scopus, Embase, and Web of Science using terminology related to oculofacial flaps. Studies were included if they utilized flap techniques for periocular repair, represented original peer-reviewed research, and met defined eligibility criteria. Data concerning patient demographics, types of defects, reconstructive techniques, results, and complications were extracted and analyzed. RESULTS: From an initial 1975 publications, 55 studies met the inclusion requirements. Techniques such as Mustardé cheek rotation, modified rhomboid, and paramedian forehead flaps were primarily utilized, with basal cell carcinoma as the principal cause of abnormalities. Complications were primarily mild, including tip necrosis (13.5%), wound dehiscence, and ectropion. Innovative methods like propeller flaps and the LOOP flap demonstrated improved cosmetic and functional outcomes for substantial defects. Challenges remain in achieving oncological safety and patient-centered aesthetics in complex reconstructions. CONCLUSION: The diversity of therapies underscores the imperative of tailoring reconstructive techniques to the particular attributes of the defect and the patient's goals. Advancements in flap design have expanded surgical options; yet, issues like result unpredictability and the necessity for long-term monitoring persist. Continuous research is vital to enhance techniques and develop innovative solutions, hence improving the quality of care for patients undergoing periocular reconstruction.

Source: BMC Ophthalmology

DOI: 10.1186/s12886-025-04512-y