Posterior lamella substitutes in full-thickness eyelid reconstruction: a narrative review

Abstract

Background and Objective: Severe full-thickness eyelid defects seriously endanger the health and beauty of the ocular surface. It is the most challenging field of oculoplastic and reconstructive surgery to reconstruct eyelid's natural appearance and function, in which the posterior eyelid lamella plays an essential role. Without enough substitute support in eyelids suffered sizeable posterior lamella defects, various complications may occur, e.g., entropion, ectropion, incomplete eyelid closure, corneal irritation, keratitis, corneal ulcers, and even vision loss, leading to failure of eyelid reconstruction. This manuscript aimed to summarize recent advances in posterior eyelid lamella substitutes and summarize the types, advantages, and disadvantages of the present posterior lamella substitutes in full-thickness eyelid reconstruction.Methods: A literature search was conducted in the PubMed database to identify relevant publications using the search algorithm "eyelid reconstruction". The full-text publication reports about posterior substitutes from January 2016 to April 2021 in English were selected and reviewed. We also screened relevant research missed in this search algorithm from the reference lists of specific full-text papers.

Polymers and Biomaterials for Posterior Lamella of the Eyelid and the Lacrimal System

“…Historically, techniques for posterior lamellar reconstruction have been reliant on replacement strategies involving implanting autografts or cell-free biomaterials in the defective area for mechanical support. Various alternatives, such as auricular cartilage, buccal mucosa, and nasal septum, have been explored [108,109]. While such biomaterials are cost-effective and easily sourced, complications such as graft contraction, graft exposure, shrinkage, and cyst formation are common.…”