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Secondary reconstruction of the eye socket in a free flap transferred after complete excision of the orbit

Reconstruction of the eye socket in a free flap transferred after complete excision for malignancy is difficult. Between 1980 and 2005 we secondarily reconstructed five eye sockets in free flaps after resection of cancer, cirsoid haemangioma, and the consequences of irradiation for retinoblastoma. Free flaps were used during the primary operations to cover the defects. The eye socket was then reconstructed during the secondary operations with a conventional skin graft in two cases, and with a skin graft using the modified Antia's method in three cases. All free flaps survived and all eye sockets accepted ocular prostheses. Three patients in particular, whose eye sockets were reconstructed using the modified Antia's method, had excellent results. Here we describe operations and problems related to secondary reconstruction of eye sockets in previously transferred free flaps after complete excision, and describe some typical cases.