Eyelid reconstruction restores form and function after tumour removal, trauma, congenital defects, or previous surgery. The aim is to protect the eye, maintain proper lid movement, and achieve good cosmetic integration.
Principles
Reconstruction often uses local flaps, grafts, and canthal repairs to rebuild both the front (skin-muscle) and back (tarsus-conjunctiva) lamellae of the lid. Techniques are chosen according to defect size, location, and involvement of lid margin.
- Small defects may be closed directly; larger ones need rotational or advancement flaps
- Free grafts from the other lid, ear cartilage, or hard palate can replace missing tarsus
- Canthal support is re‑established to keep lids aligned
- Staged procedures may be required for extensive loss
Outcomes
Successful reconstruction provides good corneal coverage, blink function, and appearance. Long‑term follow‑up is essential to monitor for tumour recurrence and structural stability.
- Short‑term swelling and asymmetry usually improve as tissues heal
- Complications can include notching, malposition, or exposure, sometimes needing revision
- Close cooperation between oculoplastic surgeons and oncologists is key in cancer cases
- Rehabilitation with lubrication and sometimes protective lenses supports the ocular surface
