Chondromucosal Nasal Flap With the Transposition Flap of Von Langenbeck as a Good Election for the Total Lower Eyelid Defect Reconstruction in an Old Patient With an Elevated Vision Loss in the Contralateral Eye

Objective: The management of lower eyelid reconstruction has a variety of treatment strategies with varying success depending on the patient. We tried to apply the most suitable reconstruction techniques for this particular case. Methods: We report a case of a 99-year-old woman, with a vision loss of 70% in the left eye and 40% in the right eye, who underwent basal cell carcinoma resection of the lower right eyelid 3 months before. The margins of resection and the deepest layers were affected. After the histopathology report, we decided to plan a more aggressive treatment with a total resection of the lower right eyelid. We had a case with 3 added difficulties: the old age of the patient, the vision loss in the contralateral eye, and the size of the resection. Results: On the basis of our experience and the bibliography reviewed, we decided to use the chondromucosal nasal flap for the posterior lamella reconstruction and the transposition flap of von Langenbeck for the anterior lamella. We found it was a good election for this patient since we achieved good functional, anatomical, and aesthetical results with a one-step operation. Conclusions: The chondromucosal nasal flap with the transposition flap of von Langenbeck was a good election for a total lower eyelid defect reconstruction in an old patient with a high vision loss in the contralateral eye.