WHEN there is a loss of more than one third of the lower lid, a lateral canthotomy and lysis of the inferior canthal tendon usually cannot alone be used to correct the defect. Other methods such as a partial-thickness lid sharing technique of Landolt-Hughes1,2 or rotational pedicle flaps, such as described by Mustardé3 are needed.
A full-thickness sharing technique was first described by Cutler and Beard.4 The lower lid was used to replace the loss of the upper lid. There generally has been a fear of using full-thickness upper lid to replace lower lid defects. It has been thought that upper lid height would be affected severely.
This article describes six patients who have undergone the technique of subtotal, full-depth, upper-to-lower lid sharing. Up to 80% of the lower lid has been replaced. Usually little or no upper lid tarsal plate is utilized in the repair of
Hecht SD. An Upside-Down Cutler-Beard Bridge Flap. Arch Ophthalmol. 1970;84(6):760-764. doi:10.1001/archopht.1970.00990040762013