LAUSR

Fig 1. Sebaceous carcinoma on the right lower eyelid of a 90-year-old woman. The figure shows the design of wide local excision and acentric axis-type propeller flap from the lateral orbital area. INTRODUCTION The incidence of skin cancers is on the rise due to population growth and aging. The eyelid region is one of the common sites for skin cancers, the majority of which are basal cell carcinoma, followed by squamous cell carcinoma and sebaceous carcinoma. Of note, the lower eyelid is more prone to be affected by skin cancers. The eyelid is composed of anterior and posterior lamellae, and when fullthickness lower eyelid defects cannot be directly closed, reconstruction of both the posterior and anterior lamellae, along with tarsal plate replacement, are typically performed. However, elderly patients with skin cancer may not be amenable to such extensive surgery. Between 1997 and 2019 at our hospital, 5 patients underwent successful reconstruction of full-thickness lower eyelid defects with the repair of only the anterior lamella while allowing the posterior lamellar portion to heal secondarily.We herein report one representative case. In addition, we discuss the clinical validity of less extensive surgery for elderly patients by allowing the posterior lamellar portions of lower eyelid defects to heal secondarily.