Abstract Listings 2024

Purpose

To report an eyelid defect that was reconstructed with an eyelid switch flap from the lower eyelid

Methods

A 76-year-old patient underwent wide local excision of a biopsy-proven sebaceous gland carcinoma on the lateral upper lid. The resulting full thickness eyelid defect involved >75% of the upper eyelid. A full thickness rotational flap from the lower eyelid was used for reconstruction. The base of the flap remained attached to the lower lid medially. A lateral canthotomy and cantholysis followed by an incision underneath the tarsal plate on the lower lid was made to mobilise the flap, which was rotated and sutured into the eyelid defect.

Results

The flap healed well and one month later, the flap was separated. Unfortunately, the released edges of the flap forming the lid margins subsequently fused. The patient underwent a successful re-separation with amniotic membrane with a good final cosmetic and functional outcome.

Conclusion

An eyelid switch flap is a useful and simple technique for eyelid reconstruction although it is rarely used. As both the anterior and posterior lamellae are mobilised together, the likelihood of a flap or graft failure is reduced and the technique results in a good cosmetic and functional outcome. Care must be taken during separation to avoid ankyloblepharon formation, amniotic membrane can be used to prevent this.

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