Eyelid and ocular adnexal reconstruction

Reconstruction of an acquired defect following ocular adnexal cancer excision is a common challenge to ophthalmic plastic surgeons, and various surgical techniques may be employed during repair: With a depleting ozone layer and increasing ultraviolet radiation exposure, the incidence of eyelid cancers is on the rise, and we can expect a growing need for eyelid reconstruction. Several reconstructive techniques may be appropriate for a particular eyelid defect. The choice of procedure by the surgeon depends on the patient's age, the degree of eyelid laxity and quality of eyelid skin, the location and size of the defect, and the surgeon's preference. Regardless of the surgical procedure chosen, the goals of the procedure should be: restoration of both the anatomy and the dynamic function of the eyelid, creation of a stable eyelid margin, acceptable vertical eyelid height, adequate eyelid closure, smooth posterior epithelial surface, canthal fixation, and maximum cosmesis and symmetry. Surgeons must have a repertoire of procedures that can be used either singly or in combination to reconstruct ocular adnexal defects.