The periosteal graft and flap use in Ophthalmology

A comprehensive review of the literature using Google Scholar, PubMed and SciElo databases with all articles about the periosteum use in Ophthalmology published from 1977 to 2018.

Results:

A total of 21 studies followed the review's purpose: 9 case reports, 9 case series, 1 retrospective cohort and 2 prospective cohorts. 206 patients were submitted to the procedures with the periosteum use in the two main forms: graft and flap. The principal reasons for periosteal use were: orbital implant covering and eyelid reconstruction. Surgical outcomes were very satisfactory with low complication rates of 10.67% and minimal necessity of new surgical intervention of 2.42%.

Conclusion:

The periosteum use in Ophtalmology is a promising technique with good results so far and should always be a therapeutic option for the ophthalmologist. However, based on available data in the literature, more studies with statistical power for knowledge sedimentation in this subject are recommended.

Keywords:
Free tissue flaps; Periosteum; Ophthalmologic surgical procedures

Author	Year	Paper
Rao et al.	1977	Periosteal graft in scleromalacia
Caroll et al.	1979	Bone formation in a periosteal graft
Wolfe SA	1979	Correction of a persistent lower eyelid deformity caused by a displaced orbital floor implant
Koenig et al .	1983	The treatment of Necrotizing Scleritis with an autogenous periosteal Graft
Horowitz et al.	1984	Galeal-Pericranial flaps in head and neck reconstruction: anatomy and application
Hurwitz et al.	1989	The use of free periosteal grafts in extensive lower lid reconstruction
Portnoy et al.	1989	Surgical Management of Corneal Ulceration and Perforation
Dingeldein et al.	1990	Mooren's ulcer treated with periosteal graft
Yoshimura et al.	1995	Use of palatal mucosal graft for reconstruction of the eye socket
Beaver et al.	1996	Periocular Autografts in Socket Reconstruction
Glatt HJ	1997	Tarsoconjunctival flap supplementation: an approach to the reconstruction of large lower eyelid defects
Tse et al.	1997	Use of galeal or pericranial flaps for reconstruction pf orbital and eyelid defects
Massry et al .	1999	Frontal periosteum as an exposed orbital implant cover
Liao et al.	2005	Surgical Coverage of exposed hydroxyapatite implant with retroauriuclar myoperiosteal graft
Leatherbarrow et al.	2006	Use of the Pericranial flap in Medial Canthal Reconstruction: another application for this versatile flap
Rajabi et al.	2012	Total lower lid reconstruction: clinical outcomes of utilizing three-layer flap and graft in one session
Okumoto et al.	2013	Secondary reconstruction of a mobile eye socket 30 years after enucleation of the eyeball for retinoblastoma: a case report
Cardim et al .	2013	Canthopexy and tarsal reinforcement using a periosteal flap
Gupta et al.	2014	Salvaging recurrent scleral buckle exposure with autologous periosteal patch graft
Ibanez-Flores et al.	2015	Pericranium grafts for exposed orbital implants: An observational case-series study
Rajabi et al.	2016	A novel technique for full thickness medial canthal reconstruction; playing with broken lines
Samira et al.	2016	Rare case of bilateral perforated corneal ulcer due to gonococcal infection, managed with temporary periostealgraft

Removal site	Use destination	Number of case	Complication
-	Scleral covering	1	-
Anterior tibial	Keratoprothesis extrusion	1	1 Bone formation
Anterior tibial	Scleral covering	2	-
-	Palpebral Reconstruction	1	-
-	Corneal ulcer	2	-
Palate	Orbital cavity	3	-
Eye socket	Implant covering	5	1 Recurrent exposure
Frontal	Implant covering	15	2 Recurrent exposure
Retroauricular	Implant covering	10	2 Recurrent exposure
			1 Granuloma
Pericranium	Exposed orbital implants	7	1 Granuloma
		Total = 47	Total = 7

Removal site	Use destination	Number of case Complication
Pericranium	Orbital reconstruction	2	-
Eye socket	Palpebral Reconstruction	75	4 cases partial remission
Nasal bone	Palpebral Reconstruction	58	-
Pericranium	Palpebral Reconstruction	24	1 Infection, 2 Ectropion, 1 Ptosis
			5 Partial ischemia,
			1 Total ischemia
		Total = 159	Total = 14

Collection technique	Destination	Number of Cases	Complications
Graft	Implant covering	22	2 Recurrent Exposures 1 Granuloma
Flap	Orbital reconstruction	2	-
	Palpebral Reconstruction	24	1 Infection, 2 Ectropion, 1 Ptosis 5 Partial ischemia, 1 Total ischemia
		Total 48	Total 13

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[1] Corresponding author: Felipe Baccega, Rua Oscar Freire, 1758. Apto 114B, Phone: (11)985354218. E-mail:felipebaccega@gmail.com