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The surgical management and outcomes of kissing nevi of the eyelids

Eye volume 37, pages 3015–3019 (2023)Cite this article

Subjects

Abstract

Purpose

To describe the clinical characteristics, surgical technique, and outcomes in patients with kissing nevi who underwent surgical management in two tertiary referral centers.

Methods

Medical chart review was conducted for all patients who underwent surgical repair in Moorfields Eye Hospital and The Children’s Hospital of Philadelphia. Demographics, medical history, lesion characteristics, surgical intervention, and outcomes were collected. Main outcome measures were surgical interventions as well as functional and cosmetic outcomes.

Results

Thirteen patients were included. Mean age at presentation was 23.46 years (±19.35,4–61), and the mean number of surgeries per patients was 1.9 (±1.3,1–5). Initial procedure included incisional biopsy in three cases (23%) and complete excision and reconstruction in 10 cases (77%). Surgery involved the upper and lower anterior lamella in all cases, the upper posterior lamella in 4 patients (31%), and the lower posterior lamella in 2 patients (15%). Local flaps were utilized in 3 cases and grafts in 5 cases. Complications included: trichiasis (n = 2, 15%), lower eyelid ectropion (n = 2, 15%), mild ptosis (n = 1, 8%), and upper/lower punctal ectropion (n = 1, 8%). Twelve patients (92%) were satisfied with the final functional and cosmetic outcome. No recurrence or malignant transformation were observed in any patient.

Conclusion

The surgical management of kissing nevi can be challenging, and commonly includes the use of local flaps or grafts, often requiring multiple interventions. The approach should be based on lesion size and location, proximity and involvement of key anatomical landmarks, as well as individual facial characteristics. Surgical management has a favorable functional and cosmetic outcome in the majority of patients.

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Fig. 1: A 21-year-old lady who has a “Kissing nevus” since birth.
Fig. 2: At the age of 4, this patient had extensive involvement of the lids by a congenital nevus.
Fig. 3: A 5-year-old patient with temporal kissing nevus that underwent reconstruction using skin graft and local advancement flap.

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Acknowledgements

The data that support the findings of this study are available on request from the corresponding author and after approval of the local IRB. The data are not publicly available due to containing information that could compromise the privacy of research participants. Patient consent has been received for the publication of Figs. 1, 2, and 3.

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Authors and Affiliations

  1. Adnexal Service, Moorfields Eye Hospital, London, England

    Ofira Zloto & David H. Verity

  2. Goldschleger Eye Institute, and the Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel

    Ofira Zloto, Daphna Landau Prat & Guy Ben Simon

  3. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Ofira Zloto, Daphna Landau Prat & Guy Ben Simon

  4. Division of Ophthalmology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Daphna Landau Prat, James A. Katowitz & William R. Katowitz

Authors
  1. Ofira Zloto
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Contributions

OZ: Conception or design of the work, Data collection, Data analysis and interpretation, Drafting the article, Critical revision of the article, Final approval of the version to be published. DL: Data collection, Data analysis and interpretation, Critical revision of the article, Final approval of the version to be published. JAK: Critical revision of the article, Final approval of the version to be published. WRK: Critical revision of the article, Final approval of the version to be published. GBS: Critical revision of the article, Final approval of the version to be published. DHV: Conception or design of the work, Data collection, Critical revision of the article.

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Correspondence to Ofira Zloto.

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Zloto, O., Landau Prat, D., Katowitz, J.A. et al. The surgical management and outcomes of kissing nevi of the eyelids. Eye 37, 3015–3019 (2023). https://doi.org/10.1038/s41433-023-02463-6

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