[Techniques for the Reconstruction of the Posterior Eyelid Lamella]

The reconstruction of the posterior lamella is basically very important for a successful and permanent eyelid reconstruction. Generally, there are no fixed rules for the technique selection. The type of care is rather determined by the individual patient's situation and the surgeon's preference. The main objective in the reconstruction of the lateral canthus is the durable fixation of the eyelids, for example, with a Tenzel flap, a periosteal flap or eccentric Hughes or Cutler-Beard procedure. In the case of central defects of the eyelid, it is important to pay attention to a regular lid margin and stable support. For the Cutler-Beard procedure, the Hughes flap or various free transplants of the rear lamella are very well suited. The medial canthus is the hardest to reconstruct; often done with a sliding graft of the lid. It is important never to combine two free transplants. Therefore, free posterior lamella grafts are combined with skin-muscle lobes. These lobes ensure a sufficient vascular supply of the posterior lamella grafts.