The use of free periosteal grafts in extensive lower lid reconstruction.

We describe using a scaffold of free periosteum as a posterior lamella replacement in the reconstruction of large defects involving the lower lid. Although the tarsoconjunctival flap is the treatment of choice in lower lid defects, the technique we describe is especially useful in cases in which it is best not to cover the eye for an extended period, and in cases involving defects extending beyond those of the lower lid.