Cilia graft.

Numerous aetiological factors can be involved in loss of eyelid substance and ideally, wherever possible, such deficits are closed by primary anastomosis. However, in the presence of extensive trauma, tumour formation, or congenital anomaly, a number of reconstructive techniques may have to be employed. These are outlined elsewhere (Smith, I959; Smith and English, 1970), but briefly to recapitulate the lower eyelid can be reconstructed by a tarso-conjunctival slide, and the upper eyelid can be fashioned with a bridge flap. Whichever of these or other procedures (Mustarde, I966) is used, one is left with the problem of a denuded lid margin of abnormal appearance. This enigma has challenged the plastic surgeon for many decades and the evolution of techniques to counter it makes instructive reading (Beyer and Smith, I97I). The cilia transplant offers the best answer to this situation.