Reconstruction of a large lateral upper and lower eyelid defect using a Mitek screw, Fricke flap and skin grafts from the eyelid.
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Case Report
Periocular basal cell carcinomas (BCC) are commonly excised and reconstructed by oculoplastic surgeons. We describe, with the aid of pictures and diagrams, a multimodal reconstruction of a large defect involving the lateral canthal angle, one-third of the upper eyelid and half of the lower eyelid with loss of lateral orbital periosteum. The eyelids were anchored with the novel use of a Prolene suture tethered to a titanium screw at the lateral orbital rim, providing structural stability. A Fricke flap was mobilised to reform the anterior lamella of the upper and lower eyelids, with the addition of an upper eyelid advancement flap and a small skin graft. The patient has had an excellent result at 15-month follow-up.
