PMC4333550_01
(a) At the time of presentation showing extensive right periorbital necrosis. (b) After first debridement showing necrotic base. (c) After second debridement showing healthy granulation and development of lagophthalmos. (d) Lateral and paramedian tarsorrhaphy to prevent corneal exposure. (e) Postoperative picture in primary gaze. (f) Postoperative picture in downgaze
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F1
At time of presentation in the ophthalmology department the periorbital skin, orbicularis oculi and underlying tissue were necrosed [Figure 1a]. An extensive debridement was done, barely 2-3 mm of upper lid skin along with the lid margin was salvageable [Figure 1b]. At the same time, lagophthalmos due to contracture was noticed [Figure 1c] for which temporal and paramedian tarsorrhaphy was performed [Figure 1d]. Follow up at 12 weeks showed a well taken up graft with lagophthalmos due to residual contracture [Figure 1e] for which patient was advised lubricating eye drops.