Arch Plast Surg.  2021 Jan;48(1):80-83. 10.5999/aps.2020.00206.

Lower eyelid fornix deepening: A new indication for the facial artery myomucosal flap

Affiliations
  • 1Reconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
  • 2Plastic and Reconstructive Unit, MSU Medical Centre, Management and Science University, Shah Alam, Malaysia
  • 3Department of Prosthodontics, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
  • 4Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Malaysia

Abstract

Eye socket contracture is a well-known late complication of enucleation surgery, and the additional insult of radiotherapy at an early age causes even further fibrosis and scarring of the socket. Management of the contracted socket is challenging, and several methods have been proposed. We report a case of eye socket contracture after enucleation and radiotherapy in which multiple reconstructive procedures failed. The recurrent contracture caused difficulty in housing and retaining the eye prosthesis. We reconstructed the lower eyelid with a facial artery myomucosal flap and nasolabial flap, and the upper eyelid with a Fricke flap following reconstruction of the orbital rims (supraorbital and infraorbital rims with a calvarial bone graft, and further augmentation of the infraorbital rim with a rib bone graft). Cosmesis post-reconstruction was acceptable and the prosthesis was retained very well.

Keyword

Orbit / Surgical flaps / Contracture / Eyelids
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