Page 173 - Manual of Equine Field Surgery

Eyelid Laceration Repair 169

COMPLICATIONS

The most frequent complication of eyelid lacera-

tion repair is wound dehiscence. This is most

commonly a result of single-layer closure, but it

may also occur as a result of devitalized wound

edges or excessive tension across the surgical site.

A B If wound dehiscence occurs, a second surgical

repair with debridement and suturing is recom-

mended to prevent eyelid margin defects and

to reduce the potential for corneal abrasion or

ulceration.

Some patients may develop a notch-like defect

of the eyelid. Such defects, if significant, can cause

abnormal tearfilm distribution, and corneal irri-

tation or ulceration. Minor defects of the eyelid

margin may be left alone if they do not adversely

affect the corneal surface; more significant defects,

C D however, require additional blepharoplastic tech-

~t?.r,v,f.<. ..:t~-- niques to correct or remove the defect. These

eyelid margin defects are most easily prevented by
Figure 29-1 Schematic demonstrating A, B, subcon-

junctival closure and C, figure-of-eight suture at eyelid two-layer closure and a.11 appropriately placed

margin. D, The reminder of the skin laceration is closed figure-of-eight suture at the eyelid margin.2

in a simple interrupted pattern.

REFERENCES

1. Brooks DE, Wolf D: Ocular trauma in the horse,

I
POSTOPERATVE CARE Equine Vet J (Suppl) 2:141, 1983.
2. Millichamp NJ: Ocular trauma, Vet Clin N Am

Equine Pract 8:521, 1992.
. . .
Postoperative Care "' ··.· .. 3. Moore CP: Eyelid and nasolacrimal disease, Vet Clin

N Am Equine 8:499, 1992.
Medications: Systemic and topical broad-spec- 4. Samuelson D: Ophthalmic anatomy. In Gelatt KN,

trum antibiotics are used initially pending culture editors: Veterinary ophthalmology, ed 3, Philadel-

and susceptibility of the affected area, and tetanus. phia, 1999, Lippincott, Williams & Wilkins.

prophylaxis should be given. Appropriate antibi- 5. Cooley PL: Normal equine ocular anatomy and eye

otics are continued for 7 days. Nonsteroidal anti- examination, Vet Cli11 N Am Equine Pract 8:427,

inflammatory therapy is necessary for a minimum 1992.

of 3 clays. 6. Moore CP, Constantinescu GM: Surgery of the

other: Cold compresses should be applied post- adnexa, Vet Clin N Am Small Anim Pract 27:1011,

operatively to combat inflammation and edema. 1997.

Protedion: Protective eye cups are recom- 7. Miller TR: Eyelids. In Auer JA, Stick JA, editors: Equin.e

mended to prevent self-trauma.2•3 surgery, ed 2, Philadelphia, 1999, WB Saunders.