Reconstruction of the medial eyelid

We used a free tarsal-conjunctival grate from the upper eyelid and a nasal-based pedicle skin-muscle flap for reconstruction of the medial aspect of the lower eyelid. This had the advantage of confining the reconstruction to the local area and eliminated the need for a temporal flap or an eyelid sharing procedure that necessitates occluding the fissure for several weeks.