A dynamic reconstruction of the upper eyelid with a reversed orbital septum flap

We used the reversed orbital septum for reconstruction both of an upper eyelid defect and movement caused by resection of Meibomian carcinoma. The surface of the orbital septum cosmetically had an appearance similar to normal mucosa. This reconstruction was made dynamic by the connection of the orbital septum with levator aponeurosis. The skin defect was closed with surplus skin as a skin-muscle flap. All materials required for this new method were obtained from the recipient's upper eyelid tissues, except for ear cartilage, so that its texture was natural and donor sacrifice was minimal. This procedure requires surplus skin, some area of orbital septum, and connection of the orbital septum with levator aponeurosis. We believe this new procedure provides a good dynamic reconstruction of the upper eyelid.