Eyelid Reconstruction

The techniques for eyelid reconstruction depend on age and the skin type, the size of the area to be repaired and whether is the lower or upper eyelid which is affected.

The process involves repair of two layers. On the front surface of the lid, skin cover can either be provided by a) sliding or rotating grafts from adjoining areas like one of the other lids, cheek or temple region and b) free skin grafts from the upper eyelids of the same or opposite side or from behind the ear.

On the back surface of the lid, there must be a smooth, moist surface to slide over and protect the eye. Suitable materials include conjunctiva from the same or opposite eye or occasionally lining of the cheek inside the mouth.

In most cases the reconstruction can be accomplished as a single procedure. In other situations, the procedure may be divided into two stages. During the first stage, the eye may require closure, especially if tissues of the upper or lower lid of the same side have been used to cover the gap. After the graft has healed and has become viable which can take 6-9 weeks, the flap is divided during the second stage.

It is not always possible to determine the best procedure for lid
reconstruction before the procedure has begun. If the tear duct is removed as part of tumor resection, a watering eye results. With repeated surgery, it is always possible to achieve a reasonable good result, but it is never possible to make an eyelid as perfectly formed as the original one.