Bridge flap reconstruction of the lower eyelid.

Although numerous conditions may result in lo,s of eyelid tissue, the aetiological agent generally concerned is one of trauma, tumour, or congenital anomaly. Ideally, wherever possible, this is rectified by primary anastomo3is with or without cantholysis. Howevcr, in the face of a large deficit, other techniques are employed (Smith, I959; Mustarde, I966; Smith and English, I970). In such circumstances a conventional manner of restoration of the lower eyelid is the tarso-conjunctival slide operation (Fig. i) perfected by Hughes (I954). The anatomical limitation of the lower eyelid which has a narrow tarsus precludes this manoeuvre for reconstruction of the upper eyelid. In America Cutler and Beard (1 955) have devised an ingenious bridge flap technique.