Reconstructive Surgery for Eyelid Defects

  • Roman ShinderEmail author
  • Bita Esmaeli
Part of the M.D. Anderson Solid Tumor Oncology Series book series (MDA, volume 6)


With a depleting ozone layer and increasing ultraviolet radiation exposure, the incidence of eyelid cancers is on the rise, and we can expect a growing need for eyelid reconstruction. Several reconstructive techniques may be appropriate for a particular eyelid defect. The choice of procedure by the surgeon depends on the patient’s age, the degree of eyelid laxity and quality of eyelid skin, the location and size of the defect, and the surgeon’s preference. Regardless of the surgical procedure chosen, the goals of the procedure should be restoration of both the anatomy and the dynamic function of the eyelid, creation of a stable eyelid margin, acceptable vertical eyelid height, adequate eyelid closure, smooth posterior epithelial surface, and maximum cosmesis and symmetry.


Lower Eyelid Advancement Flap Eyelid Margin Rotation Flap Lateral Canthus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Patrinely JR, Marines HM, Anderson RL. Skin flaps in periorbital reconstruction. Surv Ophthalmol 1987;31:249–61.PubMedCrossRefGoogle Scholar
  2. 2.
    Arthurs BP. Tumor excision and eyelid reconstruction. In: Della Rocca RC, Bedrosian EH, Arthurs BP, editors. Ophthalmic Plastic Surgery Decision Making and Techniques. New York, NY: McGraw-Hill, 2002:117–35.Google Scholar
  3. 3.
    Harvey J. Modified “double Z-plasty” in the closure of medial canthal defects. Ophthalmic Surg 1987;18:120–2.PubMedGoogle Scholar
  4. 4.
    Hughes WL, editor. Reconstructive Surgery of the Eyelids, second edition. St. Louis, MO: Mosby, 1954.Google Scholar
  5. 5.
    Smith B, Lisman R. Preparation of split thickness auricular cartilage for use in ophthalmic plastic surgery. Ophthalmic Surg 1982;13:1018–21.PubMedGoogle Scholar
  6. 6.
    Baylis HI, Rosen N, Neuhaus RW. Obtaining auricular cartilage for reconstructive surgery. Am J Ophthalmol 1982;93:709–12.PubMedGoogle Scholar
  7. 7.
    Anderson RL, Weinstein GS. Full thickness bipedicle flap for total lower eyelid reconstruction. Arch Ophthalmol 1987;105:570–6.PubMedCrossRefGoogle Scholar
  8. 8.
    Anderson RL, Jordan DR, Beard C. Full-thickness unipedicle flap for lower eyelid reconstruction. Arch Ophthalmol 1988;106:122–5.PubMedCrossRefGoogle Scholar
  9. 9.
    Leone CR, Van Gemert JV. Lower lid reconstruction using tarsoconjunctival grafts and bipedicle skin–muscle flap. Arch Ophthalmol 1989;107:758–60.PubMedCrossRefGoogle Scholar
  10. 10.
    Hewes EH, Sullivan JH, Beard C. Lower eyelid reconstruction by tarsal transposition. Am J Ophthalmol 1976;81:512–4.PubMedGoogle Scholar
  11. 11.
    Kanski JJ, editor. Clinical Ophthalmology: A Systematic Approach, fifth edition. London: Butterworth Heinemann, 2003:25–6.Google Scholar
  12. 12.
    Putterman AM. Viable composite grafting in eyelid reconstruction. Am J Ophthalmol 1978;85:237–41.PubMedGoogle Scholar
  13. 13.
    Cohen MS, Shorr N. Eyelid reconstruction with hard palate mucosa grafts. Ophthal Plast Reconstr Surg 1992;8:183–95.PubMedCrossRefGoogle Scholar
  14. 14.
    Siegel RJ. Palatal grafts for eyelid reconstruction. Plast Reconstr Surg 1985;76:411–4.PubMedCrossRefGoogle Scholar
  15. 15.
    Brown BZ. The use of homologous tarsus as a donor graft in lid surgery. Ophthal Plast Reconstr Surg 1985;1:91–5.PubMedCrossRefGoogle Scholar
  16. 16.
    Hurwitz JJ, Corin SM, Tucker SM. The use of free periosteal grafts in extensive lower lid reconstruction. Ophthalmic Surg 1989;20:415–9.PubMedGoogle Scholar
  17. 17.
    Jordan DR, Tse DT, Anderson RL, et al. Irradiated homologous tarsal plate banking: a new alternative in eyelid reconstruction: part II. Human data. Ophthal Plast Reconstr Surg 1990;6:168–76.PubMedCrossRefGoogle Scholar
  18. 18.
    Tenzel RR. Reconstruction of the central one-half of an eyelid. Arch Ophthalmol 1975;93:125–6.PubMedCrossRefGoogle Scholar
  19. 19.
    Tenzel RR, Stewart WB. Eyelid reconstruction by the semicircle flap technique. Ophthalmology 1978;85:1164–9.PubMedGoogle Scholar
  20. 20.
    Levine MR, Buckman G. Semicircular flap revisited. Arch Ophthalmol 1986;104:915.PubMedCrossRefGoogle Scholar
  21. 21.
    Cutler NL, Beard C. A method for partial and total upper eyelid reconstruction. Am J Ophthalmol 1955;39:1.PubMedGoogle Scholar
  22. 22.
    Leone CR. Lateral canthal reconstruction. Ophthalmology 1987;94:238–41.PubMedGoogle Scholar
  23. 23.
    Holt JE, Holt GR, Van Kirk M. Use of temporalis fascia in eyelid reconstruction. Ophthalmology 1984;91:89–93.PubMedGoogle Scholar
  24. 24.
    Howard GR, Nerad JA, Kersten RC. Medial canthoplasty with microplate fixation. Arch Ophthalmol 1992;110:1793–7.PubMedCrossRefGoogle Scholar
  25. 25.
    Dortzbach RK, Hawes MJ. Midline forehead flap in reconstructive procedures of the eyelids and exenterated socket. Ophthalmic Surg 1981;12:257–68.PubMedGoogle Scholar
  26. 26.
    Teske SA, Kersten RC, Devoto MH, et al. The modified rhomboid transposition flap in periocular reconstruction. Ophthal Plast Reconstr Surg 1998;14:360–6.PubMedCrossRefGoogle Scholar
  27. 27.
    Spinelli HM, Jelks GW. Periocular reconstruction: a systematic approach. Plast Reconstr Surg 1993;91:1017–24.PubMedCrossRefGoogle Scholar
  28. 28.
    Lowry JC, Bartley GB, Garrity JA. The role of second-intention healing in periocular reconstruction. Ophthal Plast Reconstr Surg 1997;13:174–88.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Section of Ophthalmology, Department of Head and Neck SurgeryThe University of Texas M.D. Anderson Cancer CenterHoustonUSA

Personalised recommendations