Use of subdermal hyaluronic acid injections and a free labial mucocutaneous graft for the repair of feline eyelid agenesis

Objective To describe a technique to repair feline eyelid agenesis using a hyaluronic acid (HA) subdermal filler injection to allow for acute soft tissue expansion, followed by a free labial mucocutaneous graft. Materials and methods Thirty‐nine colobomatous eyelids in 24 feline patients with secondary keratitis were recruited to the study group. Results Keratitis and trichiasis were markedly resolved in 27/39 (69.2%) eyelids after a single procedure. Post‐operative HA subdermal filler injections were required to resolve 5/39 (12.8%) eyelids that had mild post‐operative trichiasis, and 1/39 (2.5%) eyelids that had post‐operative lateral canthal collapse. Complications occurred in 6/39 (15.4%) cases, consisting of distal graft necrosis (n = 2 eyes), suture rubbing the cornea (n = 2 eyes), moderate trichiasis (n = 1 eye) and graft adherence to the episclera (n = 1 eye). Conclusion The technique was successful in enhancing corneal protection, cosmesis and eyelid function and should be considered as a surgical option for any degree of eyelid agenesis in feline patients.