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Reconstruction of Large Upper Eyelid Defects With Bilobed Flap and Tarsoconjunctival Graft

Purpose: To describe the reconstruction of large upper eyelid defects with bilobed flap and tarsoconjunctival graft. Methods: The medical records of 5 patients who underwent upper eyelid tumor excision and eyelid reconstruction with a bilobed flap were reviewed. Various parameters, including demographic and clinical data, defect diameter, primary defect closure, complications, and follow-up time, were recorded. After tumor excision, the posterior lamella was reconstructed with an autologous tarsoconjunctival graft and anterior lamella with a superiorly based lateral bilobed flap. Results: All 5 patients (3 women, 2 men; age: 42–87 years) had malignant epidermal (n = 2) or adnexal (n = 3) tumors. Mean excisional defect diameter was between 18.5 and 25 mm. In all patients, the anterior lamellar defect was closed primarily with a bilobed flap. After surgery, a total of 4 complications occurred in 3 patients. One patient required orbital exenteration because of tumor recurrence. In the other patients, the functional and esthetic results were satisfactory. Follow-up time ranged from 4 to 102 months. Conclusion: Lateral periorbital bilobed flap can be a good alternative for the single-stage reconstruction of large upper eyelid defects. Large, full-thickness upper eyelid defects can be reconstructed successfully in 1 stage, using tarsoconjunctival graft and superiorly based lateral periorbital bilobed flap.