Effectiveness Observation of Conjunctival Flap Transposition Combined With Placement of Lacrimal Ducts for the Repair of Eyelid Tumor Excision Involving the Lacrimal Point

Abstract

Background: Surgical excision of tumors near the lacrimal punctum presents challenges due to the risk of damaging the lacrimal duct, leading to chronic epiphora. Effective reconstruction is essential to preserve lacrimal function and maintain esthetic outcomes. This study discusses the short- to mid-term results of nine cases using conjunctival flap transposition and artificial lacrimal duct placement for repair, considering the duct's anatomical and functional aspects. Case Report: We report on nine patients with benign lesions involving the lacrimal punctum at our hospital from August 2019 to September 2022. A conjunctival flap with a reasonable design based on the defect area was used to cover the defect, and double-tube placement of artificial lacrimal ducts was performed along with suturing of the remaining lacrimal point and lacrimal canaliculus epithelium. Pathological examination of all nine patients after surgery showed "melanocytic nevus." The conjunctival flap survived in the first phase, the lacrimal point remained unblocked, there were no abnormalities in the lower eyelid or medial canthus, the appearance was aesthetically pleasing, lacrimal duct irrigation was unobstructed, and there was no tearing after surgery. All patients were followed up for more than 1 year, and no tumor recurrence or obstruction in the lacrimal duct was observed. Conclusions: Conjunctival flap transposition and artificial lacrimal duct placement is an effective surgical approach for the repair of defects following lacrimal punctum tumor excision. The method not only preserves lacrimal duct function but also achieves satisfactory esthetic results, making it a reliable choice for clinical application.

Keywords: conjunctival flap transposition; eyelid tumor; lacrimal point; melanocytic nevus.