Large upper eyelid full-thickness defects reconstructed only with an anterior lamella

The purpose of this study is to report a surgical procedure that only uses anterior lamella structures (muscle and skin) to reconstruct large upper eyelid full-thickness total defects.

The study design is a non-comparative retrospective interventional small case series. Three patients with upper eyelid full-thickness (anterior and posterior lamellae) total-defect (horizontal extent: > 3/4 length, vertical extent: > 15 mm) after tumor excision (basal cell, squamous cell, or Merkel's cell carcinoma). As intervention an eyelid reconstruction using only a rotation/advancement muscular-skin flap was used. The outcome was postoperatively an upper eyelid anatomic cosmetic-appearance and lid-closure function.

Good anatomic cosmetic-appearance and lid-closure function were achieved soon after surgery. No remarkable ocular as well as extra-ocular side effects or complications were noted.

In a single-stage procedure it appears possible to repair upper eyelid full-thickness total defects by reconstructing only the anterior lamella. With this procedure there is no need to reconstruct the posterior lamella and/or to use tissue from other eyelids or parts of the body.