Total Eyelid Reconstruction in the Anophthalmic Orbit Simplified: The Trilamellar Temporoparietal Fascia Flap

Total eyelid reconstruction poses a challenge to the reconstructive surgeon. In the anophthalmic orbit, the reconstructive goals are more limited than in a functional, seeing eye. Eyeball protection is obviously not an issue, and the goal is to create a cosmetically acceptable autologous structure capable of retaining and accommodating an ocular prosthesis. A number of techniques have been described for the reconstruction of the total loss of both eyelids. However, reconstruction of both eyelids in the anophthalmic orbit has received less attention in the literature. A simplified technique for total eyelid reconstruction in anophthalmic orbits is described herein, with a trilamellar construct using the temporoparietal fascia flap and skin grafts. The palpebral fissure is created under local anesthesia 3 weeks after the index procedure with an acceptable cosmetic result.