"Floating Island Flap"-A New Technique for the Reconstruction of Full-Thickness Lower Eyelid Defects with Spontaneous Healing (Folded V-Y Island Flap with Orbicularis Oculi Muscle)

Background: Due to the high incidence of malignant tumors of the lower eyelids and the widespread use of surgery for their treatment, the reconstruction of tissues in this area is a frequent task for surgeons. Methods for restoring full-thickness lower eyelid defects are often invasive, pose a significant risk of complications, and do not provide optimal results. Methods: The authors developed a simple technique for the reconstruction of full-wall defects of the lower eyelids. It is a V-Y-type musculocutaneous island flap from the lower eyelid, with the orbicularis oculi muscle folded in the upper part and partially left for spontaneous healing, called by the authors a "floating island flap". Between 2012 and 2023, 39 patients were operated on using this method. Results: Surgical procedures performed under local anesthesia were well tolerated by the patients. The healing process was quick and well accepted. Complications were rare. The most common were: eye irritation and temporary swelling of the flap. In 37 patients, proper protection of the eyeball and good esthetic results were achieved; only in two cases was the cosmetic result assessed as poor. Corneal defects occurred in two cases and healed after conservative treatment. In no cases was reoperation necessary. Conclusions: The developed method is simple and effective. It can be widely used in the reconstruction of full-thickness defects of the lower eyelids.