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TodAy's VeTerinAry PrAcTice | July/August 2015 | tvpjournal.com obserVATions in oPhThAlmology Peer reviewed 78 neoplasm margins. The eyelid margin is apposed with a figure-of-8 suture pattern using 5-0 or 6-0 monofilament nylon. The 4-sided wedge technique is more advantageous because it provides equal tension across the defect and prevents an obvious notch defect, while the V wedge technique leaves a small notch after surgery. • eyelid masses involving 25% to 50% of the lid: A split or full-thickness graft is advised and h-figure plasty is preferred. • eyelid masses exceeding 50% of the lid: A semicircular skin flap is advised and permits medial movement of the eyelid to increase the size of the palpebral fissure. • eyelid masses involving between 60% and 90% of the lid: reconstructive blepharoplasty is recommended with use of an h-figure plasty technique, sliding skin graft, sliding Z plasty, or whole-lid graft to successfully remove the eyelid neoplasm and preserve the portion of Table 2. Common eyelid Neoplasms 7 NeOplasM NOtes Meibomian gland neoplasms (Figure 11, page 77) • Include adenomas and adenocarcinomas • Commonly erupt behind the eyelid margin through the palpebral conjunctiva • Usually cause local irritation, resulting in epiphora, conjunctival hyperemia, pigmentation, and blepharospasm Eyelid melanomas (Figure 12) • Two forms: 1. Eyelid skin tumor with single or multiple pigmented neoplasms 2. Pigmented eyelid margin tumor with expansion in both directions • More locally aggressive than meibomian gland neoplasms • Signifcantly more benign behavior than melanomas that appear elsewhere (eg, mouth or other parts of skin) Papillomas • Represent approximately 10% to 20% of eyelid neoplasms • Most commonly affect young dogs • Viral origin and typically regress with time • Intervention necessary only when corneal involvement with direct irritation present Squamous cell carcinomas (Figure 13) • Do not routinely affect the canine eyelid • Can be seen as proliferative ulceration Fibromas or fbrosarcomas • Uncommon • Primarily seen as subcutaneous masses affecting the eyelids FIGURE 12. Ten-year-old spayed female mixed breed dog with melanoma. Note the large pigmented mass with ulceration, discharge, and hemorrhage causing local invasion of the inferior eyelid and associated adnexal structures. Surgical correction with a reconstructive blepharoplasty using an H-fgure plasty technique was curative. Histopathologic examination was consistent with melanoma. No additional disease was found systemically. Courtesy Dr. Ellen B. Belknap FIGURE 13. Eleven-year-old spayed female Labrador retriever with squamous cell carcinoma. Note the extensive ulceration and hemorrhage of the mass, which is affecting surrounding eyelids and invading the medial canthus and superior and inferior eyelid. Surgical correction with reconstructive blepharoplasty using a whole-lid graft technique was performed. Referral to an oncologist was recommended for further treatment. Courtesy Dr. Ellen B. Belknap