Sandwich Block for Eyelid Reconstruction

Purpose: To report on a one-stage technique for eyelid reconstruction with preservation of the eyelid margin. Design: Prospective study. Methods: Five patients with small-to-intermediate full-thickness lower eyelid defects (n = 3) and upper eyelid defects (n = 2) after tumor excision. Defect size ranged from 5 to 7 mm vertically and from 7 to 12 mm horizontally. For eyelid reconstruction, a full-thickness pentagonal graft from the opposite lid was sutured into the full-thickness defect after removal of the orbicularis oculi muscle from the graft. The orbicularis muscle flap from the recipient eyelid was mobilized and brought in for vascular supply between tarsus and skin of the graft. The outcome after surgery was assessed using a subjective scoring system with 4 subsequent grades. Results: At 1 week postoperatively, adequate viability of the grafts was noted in all patients. After a mean follow-up of 13 months (range 3-33 months) the cosmetic and functional outcome was adequate in 1 case, good in 2 cases, and excellent in 2 cases. Conclusion: Reconstruction of small to intermediate full-thickness defects of both lower and upper eyelid with the "sandwich block"-technique is associated with a good functional and cosmetic outcome.