Abstract
We present a case of a 75-year-old patient who underwent reconstruction of the lower eyelid and lateral canthus following removal of 80% of the lower eyelid due to basal cell carcinoma. A Hughes transconjunctival eyelid-sharing flap was used to form the posterior lamella, and a free skin graft from the ipsilateral upper lid was used to recreate the anterior lamella. The lateral canthal ligament was reconstructed using a free fascia lata graft. A periosteal flap was not used due to local scarring that was the result of previous multiple lateral canthal surgeries. Skin preservation in the lateral canthal area and additional horizontal support for the lower eyelid were achieved by using a local advancement flap. This two-stage surgery produced excellent functional and cosmetic effects. Fascia lata free graft can be an alternative to the periosteal flap for reconstruction of the lateral canthal ligament when use of the lateral orbital periosteum is not feasible.
Highlights
Facial skin, especially in the lower eyelid, is a common site of basal cell carcinoma due to sunlight exposure
Fascia lata free graft can be an alternative to the periosteal flap for reconstruction of the lateral canthal ligament when use of the lateral orbital periosteum is not feasible
After a lower eyelid lesion has been completely removed using histopathological confirmation, the resulting orbital tissue defects may be closed with either local advancement flaps, such as a horizontal V-Y advancement lower eyelid flap, or free grafts depending on their extent [1,2]
Summary
Especially in the lower eyelid, is a common site of basal cell carcinoma due to sunlight exposure. To the best of our knowledge, this case presentation is one of very few reports to describe the use of a fascia lata free graft to reconstruct the lateral canthal ligament combined with the Hughes transconjunctival eyelid-sharing flap in a patient with a significant defect in the lower eyelid that includes the lateral canthus. This manuscript was written in compliance with the rules and regulations of the Declaration of Helsinki
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