Staged plastic and reconstructive surgery of lower eyelid defect after the excision of basal cell carcinoma

Purpose. Evaluation of the effectiveness of multi-staged plastic and reconstructive rehabilitation of the patient with a large lower eyelid defect after the excision of basal cell carcinoma. Material and methods. The patient L., 75 years old, was treated with postoperative coloboma of the lower eyelid, lagophthalmos of the right eye after removal of the eyelid basal cell carcinoma, applied to the S.N. Fyodorov Eye Microsurgery Federal State Institution in Moscow. She underwent a multi-stage reconstructive plastic treatment in order to restore the anatomy and function of the lower eyelid, eliminate the cosmetic defect. Results and discussion. As a result of the first surgical stage, we were able to restore the skin defect using a free skin flap from the upper eyelid of the left eye. The second stage of treatment allowed us to restore the function of the lower eyelid by eliminating the artificial ankyloblepharone created earlier. The consequence of performing the following stages of surgery was the filling of the lack of the mucous membrane of the lower eyelid, the creation of the correct ratio and position of the cutaneous and conjunctival layers of the eyelid, the elimination of lagophthalmos and the restoration of anatomical and functional characteristics of the eyelid. Conclusion. As a result of multi-stage surgical treatment, the anatomical and functional integrity of the lower eyelid was achieved, prevented the loss of visual functions, achieved a satisfactory cosmetic effect, and also improved the patient's quality of life. Keywords: basal cell carcinoma, lower eyelid, staged plastic and reconstructive surgery