Split-level full-thickness eyelid graft

A new method of surgical treatment for cicatricial eyelid retraction involves grafts placed in both the anterior and posterior lamellae of the upper eyelid, when there is a shortage of tissue in both layers, caused by previous surgical procedures. The anterior lamellar graft is of postauricular skin and the posterior graft is of buccal mucosa. The two grafts are placed at different levels in the eyelid so that each has a viable vascular bed. The procedure, called the split-level full-thickness eyelid graft, is not designed to correct problems involving only the eyelid retractors, such as retraction secondary to thyroid disease.