Purpose

Severe chemical burns to the periocular region present complex reconstructive challenges, often resulting in devastating functional and aesthetic deficits. We present an unusual challenging case of bilateral, four-eyelid reconstruction following a profound acid chemical burn.

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Methods

A rare case of a reconstruction of bilateral four eyelid defect 12 months following profound acid chemical burn.

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Results

A 24-year-old male was admitted with full-thickness structural loss across all four eyelids, complicated by severe lagophthalmos approximately 12 months secondary to profound acid burn. Prior to definitive surgery, aggressive medical management utilizing prophylactic antibiotic ointments and artificial tear gels was employed to mitigate exposure keratopathy and protect the ocular surface. Bilateral, four-eyelid reconstruction surgery with flaps and grafts was performed. At the 3-month postoperative follow-up, the patient demonstrated acceptable anatomical integration of all grafts and flaps with minimal secondary contracture.

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Conclusion

Bilateral four-eyelid defects following profound acid injuries necessitate highly individualized surgical planning, even months after the initial trauma. A reconstructive strategy utilizing varied autologous grafts and local flaps for dual-lamellar repair can successfully restore eyelid biomechanics, safeguard the ocular surface, and yield acceptable functional and cosmetic outcomes following severe chemical burns.

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Additional Authors

First name	Last name	Base Hospital / Institution
Buse	Gürcan	Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Ophthalmology Department

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