Purpose: 

While Wendell Hughes popularized the tarsoconjunctival flap for lower eyelid reconstruction, most modern procedures are derived from the technique described by Köllner in 1911. This study reviews the history, techniques, and outcomes of a large series of patients treated with a modified Köllner flap.

Methods: 

In this observational cohort study, medical records and photographs were reviewed in patients undergoing surgery between 2005 and 2020. Patient demographics, complications, secondary interventions, and outcomes were evaluated.

Results: 

Marginal defect size ranged from 12 to 41 mm among the 140 study patients. Ancillary procedures included lower eyelid conjunctival flaps (n = 64) and septal orbicularis flaps (n = 68). The anterior lamella was reconstructed with skin grafts (n = 86), flaps (n = 10), or combined flaps/grafts (n = 44). Pedicle division was performed 23 to 84 days after primary repair. Subsequent interventions included steroid injection (n = 10), cryotherapy (n = 10), marginal erythema treatment (n = 9), and upper eyelid retraction repair (n = 6). Tearing (6.5%) and dryness (10%) were the most common postoperative symptoms, with most patients (78.6%) being asymptomatic. A good-excellent functional outcome was achieved in 94.3% and cosmetic outcome in 85.0% of cases. Defects <30 mm in width (P = 0.0001), defects not involving a canthus (P = 0.0158), and upper eyelid skin graft donor sites (P = 0.0001) were associated with better outcomes.

Conclusions: 

The Köllner tarsoconjunctival flap is an effective technique to repair moderate-large lower eyelid defects, with the majority of patients achieving good-excellent cosmetic and functional outcomes. Factors associated with a poorer result include marginal eyelid defects ≥30 mm in width, defects involving a canthus, and non–upper eyelid skin graft donor sites. Most patients are asymptomatic after surgery.

中文翻译：

---

用于下眼睑重建的 Köllner Tarsoconjunctival 皮瓣：140 例病例的历史观点和手术结果

目的： 

虽然 Wendell Hughes 普及了用于下眼睑重建的睑结膜瓣，但大多数现代手术都源自 Köllner 在 1911 年描述的技术。本研究回顾了使用改良 Köllner 皮瓣治疗的大量患者的历史、技术和结果。

方法： 

在这项观察性队列研究中，回顾了 2005 年至 2020 年期间接受手术的患者的医疗记录和照片。评估了患者的人口统计学、并发症、二次干预和结果。

结果： 

140 名研究患者的边缘缺损大小范围为 12 至 41 毫米。辅助手术包括下眼睑结膜皮瓣 (n = 64) 和间隔眼轮匝肌皮瓣 (n = 68)。用皮肤移植物 (n = 86)、皮瓣 (n = 10) 或组合皮瓣/移植物 (n = 44) 重建前板层。初次修复后 23 至 84 天进行椎弓根分割。随后的干预措施包括类固醇注射 (n = 10)、冷冻疗法 (n = 10)、边缘红斑治疗 (n = 9) 和上眼睑回缩修复 (n = 6)。流泪 (6.5%) 和干燥 (10%) 是最常见的术后症状，大多数患者 (78.6%) 没有症状。在 94.3% 的病例中实现了良好的功能结果，在 85.0% 的病例中实现了美容效果。缺陷宽度 <30 mm ( P= 0.0001）、不涉及眼角的缺陷（P = 0.0158）和上眼睑皮肤移植供区（P = 0.0001）与更好的结果相关。

结论： 

Köllner 睑结膜瓣是修复中大下眼睑缺损的有效技术，大多数患者获得了良好的美容和功能结果。与较差结果相关的因素包括宽度≥30 mm 的边缘眼睑缺损、涉及眼角的缺损和非上眼睑皮肤移植供区。大多数患者术后无症状。