[Hard palate mucosal graft for posterior lamella repair]

Several techniques have been proposed for posterior lamella repair. The ideal gaft should be easy and safe to harvest, be lined by mucosa and be rigid enough to support the lower lid against retraction. Hard palate mucosal grafts meet these criteria. The surgical procedure is done under local or general anaesthesia and a graft up to a 40 x 20 mm can be harvested. Paramedian and subperiostal harvest is recommended, local complications are less frequent (bleeding and sensory lesions) and the hard palate mucosa is of better quality at this site (thinner graft with fewer salivary glands but rigid enough due to the periostal layer). Donor site complications such as local bleeding can be reduced by meticulous surgical technique and local postoperative care such as compression using a mouthguard. The main indications for hard palate mucosal graft are lower eyelid reconstruction and management of lower eyelid retraction.