Purpose

To present a case of staged reconstruction of severe post-traumatic lower eyelid defect and cicatricial ectropion after mine-blast injury with orbital fractures and anophthalmia.

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Methods

A 37-year-old patient sustained a mine-blast injury on July 11, 2025, resulting in right-sided anophthalmia, cicatricial deformity of the right lower eyelid, and fractures of the inferior, medial, and lateral orbital walls. The first stage included conjunctival cavity revision with placement of an intrascleral porous implant, lower eyelid reconstruction by direct edge approximation, temporary tarsorrhaphy, and placement of a patient-specific orbital implant. Postoperatively, wound dehiscence occurred, and delayed medical attention led to dense scarring of the lower eyelid and cheek with downward eyelid traction. This resulted in cicatricial ectropion with central tarsal deficiency. Six months later, second-stage reconstruction was performed using a Hughes tarsoconjunctival flap combined with a full-thickness free skin graft.

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Results

Healing after the second stage was satisfactory. The Hughes flap remained viable and was divided 21 days after surgery. A stable lower eyelid was reconstructed, improving anatomical support of the anophthalmic socket. The patient was referred for individualized ocular prosthetic rehabilitation.

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Conclusion

Severe cicatricial ectropion with partial lower eyelid loss after mine-blast injury is a complex reconstructive challenge. Combined Hughes flap and full-thickness skin graft reconstruction restored lower eyelid structure and prepared the patient for ocular prosthetic rehabilitation. Timely postoperative follow-up is essential to prevent secondary cicatricial deformities.

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Additional Authors

First name	Last name	Base Hospital / Institution
Oksana	Petrenko	Bogomolets National Medical University

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