Lateral eyelid island flap for reconstruction of large central and medial full-thickness defects of the lower eyelid

Abstract

Introduction To report our experience with lateral eyelid island flaps for reconstruction of large central and medial full-thickness defects of lower eyelid. Methods Retrospective case series of patients with large central and medial full-thickness lower lid defects repaired with medial transposition of the lateral lower lid combined with a temporal myocutaneous flap. Preoperatively the authors collected demographic data, etiology and percentage of the defects. Postoperatively the lids were assessed for flap viability and lower eyelid margin position and contour. Results The sample was comprised of 10 patients (5 females) with a mean of age 60.10 (SD 13.75) years. The defects ranging from 50% to 75% of the lid width resulted from excision of eight basal cell carcinomas, one (10%) malignant schwannoma and one (10%) squamous cell carcinoma. The median follow-up was 1.58 years (IQR 2.58). Flap ischemia was not observed in any eyelid. One mild ectropion was observed in just one lid. All patients were satisfied with the esthetic results. Conclusions Medial transposition of the lateral lower lid island flap combined with horizontal myocutaneous advancement flap is an excellent one-stage procedure that avoids the drawbacks of the two-stages procedures