Upper Eyelid Reconstruction Using the Medpor® Sheet and Median Forehead Flap

Abstract

Purpose: To report the upper eyelid reconstruction with median forehead flap and Medpor sheet implant following fullthickness eyelid defect resulting from tumor resection. Case Summary: A 65-year-old woman was examined at our hospital for a recurrent mass on the right upper eyelid. A wide tumor excision with a 3 mm margin and an eyelid reconstruction procedure were performed after a frozen section biopsy revealed a malignancy. The full-thickness eyelid defect was reconstructed with a median forehead flap as a substitute for skin and muscle and a Medpor sheet substituted for tarsal plate was sutured with a lower conjunctiva flap for posterior lamella. The histopathology diagnosis of the lesion showed a well-differentiated squamous cell carcinoma. The lower conjunctiva was separated at 2 weeks after surgery, and then the median forehead flap detached from the upper eyelid skin at 8 weeks after surgery. One year postoperatively, there was no evidence of a wound infection and an exposure of the Medpor sheet. The eyelid had a good cosmetic contour and the movement of the eyelid during blinking was natural. Conclusions: The use of a Medpor sheet as a substitute for a tarsal plate in reconstructive procedures of the upper eyelid defect shows cosmetic and functional success.