The use of mucosa-lined flaps in eyelid reconstruction: a new approach.

In this paper, a review is given of the conditions that should be fulfilled for optimal eyelid reconstruction and of the principles on which modern techniques are based. A new approach to upper-eyelid reconstruction using a bipedicled flap from the lower eyelid that is lined with a mucosal graft but has no cartilaginous support is described. Also introduced is the use of similarly lined monopedicled flaps for the reconstruction of lower-eyelid defects. With these procedures, eyelid reconstruction has become less complicated. Flaps taken from forehead or cheek are scarcely ever necessary, and problems with reconstruction can be restricted to patients who have had radiotherapy or to the rare patients in whom defects in both eyelids have to be closed.