Total upper and lower eyelid reconstruction using an expanded forehead flap.

Abstract

Surgical modalities have been described with varying success for the correction of eyelid defects. The reconstructive surgeon must choose the procedure on a case-by-case basis taking into consideration the following criteria: mechanism of injury, comorbidities, and goals of surgery. In this study, we describe a unique case of total upper and lower eyelid reconstruction using an expanded forehead flap technique in an adult patient who underwent left eye enucleation and radiation to the orbit for rhabdomyosarcoma in infancy. After this patient reached adulthood, examination revealed a contracted, anophthalmic left orbit with paper-thin upper and lower eyelids adhering to the concave walls of the orbit. There was absence of significant periorbital soft tissue. The expanded forehead flap procedure achieved our aims of providing not only an aesthetic result, but also adequate soft tissue support for placement of an ocular prosthesis.