Systematic Reviews
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Jun 18, 2025; 15(2): 97571
Published online Jun 18, 2025. doi: 10.5500/wjt.v15.i2.97571
Development and validation of a decision algorithm for eyelid reconstruction following oncological resection
Giovanni Miotti, Davide Quaglia, Federico Cesare Novati, Pier Camillo Parodi, Martina Grando, Carlo Salati, Leopoldo Spadea, Caterina Gagliano, Mutali Musa, Marco Zeppieri
Giovanni Miotti, Davide Quaglia, Pier Camillo Parodi, Department of Plastic Surgery, University Hospital of Udine, Udine 33100, Italy
Federico Cesare Novati, Department of Medical, Surgical and Health Sciences, Plastic and Reconstructive Surgery Unit, University of Trieste, Trieste 34123, Italy
Martina Grando, Department of Internal Medicine, Azienda Sanitaria Friuli Occidentale, San Vito al Tagliamento 33078, Italy
Carlo Salati, Marco Zeppieri, Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
Leopoldo Spadea, Eye Clinic, Policlinico Umberto I, “Sapienza” University of Rome, Rome 00142, Italy
Caterina Gagliano, Department of Medicine and Surgery, University of Enna “Kore”, Enna 94100, Italy
Caterina Gagliano, Mediterranean Foundation “G.B. Morgagni”, Catania 95125, Italy
Mutali Musa, Department of Optometry, University of Benin, Benin 300283, Nigeria
Mutali Musa, Department of Ophthalmology, Centre for Sight Africa, Nkpor 434112, Nigeria
Author contributions: Miotti G and Quaglia D wrote the outline; Miotti G and Quaglia D performed the research and wrote the manuscript; Zeppieri M was responsible for the conceptualization and design of the study and completed the English and scientific editing; Miotti G, Quaglia D, Novati FC, Parodi PC, Grando M, Salati C, Spadea L, Gagliano C, Musa M, and Zeppieri M assisted in the editing, making critical revisions of the manuscript and viewing all versions of the manuscript; All authors provided final approval of the article.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marco Zeppieri, MD, PhD, Department of Ophthalmology, University Hospital of Udine, p. le S. Maria della Misericordia 15, Udine 33100, Italy. markzeppieri@hotmail.com
Received: June 2, 2024
Revised: November 18, 2024
Accepted: December 5, 2024
Published online: June 18, 2025
Processing time: 263 Days and 14.4 Hours
Abstract
BACKGROUND

Eyelid reconstruction is an intricate process, addressing both aesthetic and functional aspects post-trauma or oncological surgery. Aesthetic concerns and oncological radicality guide personalized approaches. The complex anatomy, involving anterior and posterior lamellae, requires tailored reconstruction for optimal functionality.

AIM

To formulate an eyelid reconstruction algorithm through an extensive literature review and to validate it by juxtaposing surgical outcomes from Cattinara Hospital with established findings.

METHODS

The algorithm was formulated by analyzing 1538 articles, which were subsequently refined to 113 according to quality standards, and then implemented in surgical cases at Cattinara Hospital. Complication rates were examined for validity.

RESULTS

The decision algorithm was employed to apply reconstructive techniques customized to the characteristics of the eyelid defect, including its depth and location. The results exhibited a minimal complication rate, consistent with established guidelines. Validation confirmed the algorithm’s efficacy in reducing post-operative problems.

CONCLUSION

This algorithm functions as an essential decision-making instrument for eyelid reconstruction, enhancing outcomes by minimizing complications in clinical practice.

Keywords: Cartilage grafts; Decision algorithm; Eyelid lamella grafts; Eyelid reconstruction; Flap transplantation; Graft transplantation; Mucosa grafts

Core Tip: Eyelid reconstruction is a complex endeavor for plastic surgeons, as it blends functionality and aesthetics. Decision-making algorithms can streamline personalized treatment, reducing complications and reinterventions. Eyelid reconstruction aims to restore both form and function and requires the intricate evaluation of defects before treatment planning. Techniques vary from direct sutures to grafts or local flaps, guided by defect size and location. The aim of this study is to present our algorithm, which we developed through a thorough literature review and a critical retrospective analysis of the results.