Outcome of lip-to-lid subdermal plexus flaps to reconstruct defects of the lower eyelid in dogs and cats: 46 cases (2005-2022).

Objectives: To report the outcome of lip-to-lid subdermal plexus flaps in dogs and cats, the surgical and ophthalmic complications and their incidence, and the occurrence of the complications in relation to risk factors.

Materials and methods: Medical records of 11 centres were reviewed. Data from dogs and cats that underwent lip-to-lid subdermal plexus flaps between 2005 and 2024 was collected. Dogs and cats were included if they had complete medical records with a minimum of 4 weeks follow-up. The incidence of surgical and ophthalmic complications was recorded, and overall outcomes were documented.

Results: Forty-six cases were included: 15 dogs and 31 cats. Post-oncological reconstruction was the main indication in dogs (87%) and cats (80%). Optimal flap healing occurred in 10 (67%) dogs and in 26 (84%) cats. In dogs, 11 (73%) cases developed complications (60% minor, 13% major). In cats, 23 (74%) cases developed complications (70% minor, 3% major). Flap necrosis occurred in 4 of 15 dogs (27%) and 8 of 31 cats (26%). Post-operative infection occurred in 1 of 15 dogs (7%) and 1 of 31 cats (3%). Blink dysfunction was the most common ophthalmological complication occurring in five dogs and six cats. No significant difference was found between the percentage of lower eyelid excised and the development of complications (flap dehiscence, necrosis and blink dysfunction). Overall good outcome, defined as uncomplicated healing, second-intention healing and short-term topical ocular management, was achieved in 80% of dogs and 93% of cats.

Clinical significance: Lip-to-lid subdermal plexus flaps provide an excellent option for reconstruction of the lower eyelid with a high overall success rate. Minor complications are common; however, a good ophthalmological outcome is present in most of the cases.