Irradiated homologous aorta in eyelid reconstruction. Part 1: Technique and animal research

Reconstruction of full thickness eyelid defects requires the correction of posterior lamella (tarsus, conjunctiva) and anterior lamella (skin, muscle). Various tarsal substitutes--conchal and nasal cartilage, banked sclera, hard palate, irradiated homologous tarsal plates, periosteum, temporalis fascia, and composite grafts from the opposite eyelid--have been used for posterior lamellar replacement over the years. Eyelid-sharing procedures and full thickness flaps have also been described. At times, because of extensive tissue loss, the eyelid reconstruction can be particularly challenging because of the shortage of tissue. We describe a new posterior lamellar technique using irradiated homologous aorta. The experimental surgical procedure in rabbits, the clinical response, and the histological fate of the donor aorta are described in Part 1 followed by our experience with four patients in Part 2.