Novel Reconstructive Technique for Lower Eyelid Defects: Marginal Approach for Releasing the Lid with Closure Handling Technique (MARCH Technique)

<b>Background</b>: This study introduces a novel surgical approach, the Marginal Approach for Releasing the lid with Closure Handling technique (MARCH technique), a single-step sparing tissue technique, for the reconstruction of medium to large full-thickness lower eyelid defects and its outcomes. <b>Methods</b>: The research considers a single-centre case series with a description of the MARCH technique. Patients with a full-thickness medium to large lower eyelid defect underwent this technique, which combines inferior cantholysis, splitting of lamellae and island or advancement flaps. Demographic data, lid defect size, histology and postoperative outcomes were collected. <b>Results</b>: The surgical procedure was performed in fifteen patients (nine males and six females). The mean age was 73.9 years (range 48-95 years old). Local anaesthesia was used in 86.7% of cases. The mean defect size was 68.7% (range 50% to 79%) of the lid length. All patients presented good results with no significant complications. <b>Conclusions</b>: The MARCH technique seems to be an excellent first-line approach in reconstructing medium to large full-thickness lower eyelid defects. Its single-step approach, tissue-sparing and minimally aggressive nature and ability to potentially guide eyelash positioning and restore the lacrimal system with a more anatomical position make it a promising option. Enrolling more patients and a longer follow-up would provide a better assessment.