Repair of Eyelid Defects with the Orbicularis Oculi Mobilization Technique: Naugle-Levine Procedure

  • Constance L. Fry
  • Thomas C. NaugleJr
  • Mark R. LevineEmail author


Full-thickness large (>50%) defects of the upper and lower eyelids are challenging to reconstruct. The blood supply from advanced orbicularis oculi muscle flap allows for the utilization of both a skin graft and a posterior lamellar graft when desirable. The repair of eyelid defects incorporating orbicularis mobilization is particularly useful in patients who are monocular and in those patients who wish to avoid occlusion of the visual axis created by an eyelid sharing procedure. Herein, we describe the technique.


Orbicularis mobilization Orbicularis flap Free tarsoconjunctival graft Full-thickness eyelid defect Eyelid reconstruction Adjacent tissue transfer Muscle flap Naugle-Levine procedure 

Suggested Readings

  1. 1.
    Naugle TC, Levine MR, Carroll GS. Free graft enhancement using orbicularis muscle mobilization. Ophthalmology. 1995;102:493–500.CrossRefPubMedGoogle Scholar
  2. 2.
    Doxanas MT. Orbicularis muscle mobilization in eyelid reconstruction. Arch Ophthalmol. 1986;104:910–4.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Constance L. Fry
    • 1
  • Thomas C. NaugleJr
    • 2
  • Mark R. Levine
    • 3
    • 4
    • 5
    Email author
  1. 1.Department of OphthalmologyUT Health San AntonioSan AntonioUSA
  2. 2.Department of OphthalmologyTulane University Medical SchoolNew OrleansUSA
  3. 3.Department of OphthalmologyCase Western Reserve University, School of MedicineClevelandUSA
  4. 4.Oculoplastic Section, Department of OphthalmologyUniversity Hospitals of ClevelandClevelandUSA
  5. 5.Cleveland Clinic FoundationClevelandUSA

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