Abstract
Lower eyelid reconstruction requires multiple tools in an oculoplastic surgeon’s armamentarium. Although the tarsoconjunctival (Hughes) flap is reliable, the requirement of a second stage and closure of the eye are definite disadvantages to the procedure. In addition, some defects are in the gray zone between a primary closure with cantholysis and a Hughes flap. This chapter describes two different one-stage procedures for reconstruction of large full-thickness defects of the lower eyelid: one procedure employs a free tarsal graft, while the other uses a laterally based tarsoconjunctival flap.
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Video 38.1
Free tarsal graft harvest. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/4/19-free-tarsal-graft-harvest.htm (MP4 76000 kb)
Video 38.2
Repair of 50% lateral full-thickness lower eyelid defect. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/4/17-lateral-defect-w-free-tarsal-graft.htm (MP4 286168 kb)
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Barahimi, B. (2018). Tarsal-Conjunctival Graft or Flap and Skin-Muscle Transposition Flap in Lower Eyelid Reconstruction. In: Levine, M., Allen, R. (eds) Manual of Oculoplastic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-74512-1_38
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DOI: https://doi.org/10.1007/978-3-319-74512-1_38
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