Related Experiment Video
Updated: Apr 17, 2026
Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
Repeat tarsoconjunctival flap with limited tarsal support in lower eyelid reconstruction
Helena Lam1, Christopher M DeBacker1
1Department of Oculo-Facial Plastic Surgery, Eyeplastx, an NVISION Center, San Antonio, Texas, USA.
Purpose:
The Köllner-Hughes tarsoconjunctival flap is a well-known reconstructive workhorse for the repair of full-thickness lower eyelid defects but repeat use for repair of the same eyelid has been seldom reported.
Methods:
Over a fifteen-year period, two patients were identified to have undergone a successive tarsoconjunctival flap procedure following recurrent malignancies by a single oculoplastic surgeon. Using this successive technique required careful dissection in scarred tissue planes and only 1.5 mm of vertical tarsal height incorporated into the tarsoconjunctival flap.
Results:
Despite limited residual tarsal support in the flap, both cases achieved adequate lid position, corneal protection, and lid stability on long-term follow up, with no evident donor site complications at 6 months and 4 years' follow-up respectively.
Conclusions:
Repeat procedures may represent a viable reconstructive option for recurrent eyelid defects despite minimal tarsal support when alternative approaches carry greater morbidity.
