The Role of Rigid Suspension and Fixation in Treating Lagophthalmos After Lower Eyelid Reconstruction.

A patient with severe eyelid defects caused by a car accident was admitted to the Plastic Surgery Department of the First Hospital of Jilin University. The lower eyelid was first reconstructed with autogenous palatal mucosa and a temporal musculocutaneous flap, which provided adequate tissue volume. Postoperatively, eyelid closure was good. After long-term follow-up, the reconstructed lower eyelid showed laxity and downward movement. The eyelid could not close completely and lagophthalmos occurred. Then, the lower eyelid was suspended by the fascia lata. The suture at the point of fixation became loose again after the operation. Incomplete eyelid closure recurred. Finally, palmaris longus tendon graft suspension combined with screw fixation was used to obtain a satisfactory therapeutic effect. in summary, rigid suspension and fixation can provide adequate lateral tension to resist lower reconstructed eyelid shifting and lagophthalmos, which is important for the maintenance of lasting effects.