Secondary correction of the burned eyelid deformity

We describe our experience in late reconstructions of 35 burned eyelids. On this basis we advocate wide, aggressive release of all scar contractures, including the distal part of the levator when necessary. To cover the resultant defects we use generous full-thickness skin grafts, if available, for both the upper and lower lids. Rarely has a tarsorrhaphy been required, and properly constructed dressings provide satisfactory lid immobilization and permit conjunctival hygiene. During the postoperative period the vision need not be obstructed by a tarsorrhaphy, Frost sutures, or the dressings.