Stable Upper Eyelid after 2 Successive Tarsoconjunctival Flaps.

Area of Science:

• Ophthalmology
• Dermatology
• Surgical Oncology

Background:

• Cutaneous squamous cell carcinoma (cSCC) can affect the eyelid.
• Mohs surgery is a standard treatment for eyelid cSCC.
• Reconstruction of large eyelid defects can be challenging.

Observation:

• A 70-year-old male presented with recurrent lower eyelid margin cSCC after initial Mohs surgery and Hughes flap reconstruction.
• A second Mohs surgery was performed for the recurrent lesion.
• A second tarsoconjunctival flap, spanning the entire upper eyelid width, was utilized for reconstruction.

Findings:

• The second tarsoconjunctival flap successfully reconstructed the extensive lower eyelid defect.
• The remaining upper tarsus provided adequate support for the upper eyelid.
• This case demonstrates the feasibility of using successive tarsoconjunctival flaps for complex eyelid reconstruction.

Implications:

• Successive tarsoconjunctival flaps are a valuable reconstructive option for recurrent or extensive eyelid cSCC.
• Careful surgical planning is crucial for successful outcomes in complex eyelid reconstructions.
• This approach may preserve eyelid function and cosmesis in challenging cases.