Investigation of the therapeutic effect of orbital septum transfer in the reconstruction of severe eyelid defects.

Objective: To investigate the efficacy of skin flap and orbital septum transfer combined with allogeneic sclera transplantation for the reconstruction of full-thickness eyelid defects after malignant eyelid tumor resection. Methods: Twenty one patients from our hospital who were diagnosed with malignant tumors of the eyelid through pathological examination and had severe eyelid defects after extensive tumor resection, including eleven patients with eyelid basal cell carcinoma, seven patients with sebaceous gland carcinoma and three patients with squamous cell carcinoma. The tumors were all located on the lower eyelid. The anterior layer was reconstructed using upper eyelid rotational skin flap transfer, while the posterior layer was reconstructed using autologous orbital septum transfer and allogeneic sclera transplantation. After surgery, eyelid closure, eyelid and palpebral margin morphology, transplanted skin condition, local foreign body sensation, and ocular surface condition were observed. Results: All patients underwent controlled mass resection using specimen-labelled frozen sections during surgery. After that, severe eyelid defects were observed, with one patient undergoing secondary eyelid reconstruction and the remaining patients undergoing primary eyelid reconstruction. After 6-month follow-up, all the patients had satisfactory eyelid closure, satisfactory eyelid and palpebral margin morphology, no local discomfort caused by foreign bodies, smooth orbital septum, good corneal condition on the ocular surface, and no tumor recurrence. Conclusion: In terms of severe eyelid defects, the use of upper eyelid rotational skin flap transfer to reconstruct the anterior layer, autologous orbital septum transfer, and allogeneic sclera transplantation to reconstruct the posterior layer is safe, effective, and reproducible.