To evaluate the degree of eyelid deformation and satisfaction after direct closure in patients with 40–70% eyelid defects after resection of an eyelid malignant tumor.

We retrospectively reviewed the clinical records of patients diagnosed with eyelid malignant tumors between January 2009 and June 2016, who were treated with resection of 40–70% of the eyelid, followed by reconstructed direct closure only or by direct closure with lateral canthotomy and cantholysis. Age, sex, diagnosis, tumor location, satisfaction, and complications were analyzed, and the ratio of horizontal width ratio and vertical height ratio were compared before and after surgery.

The results of satisfaction were: 12 patients (60%), very good; five patients (25%), good; and three patients (15%), fair. The average preoperative horizontal width ratio and vertical height ratio were 1.03 ± 0.01 and 1.08 ± 0.30, respectively. The average postoperative horizontal width ratio and vertical height ratio were 1.04 ± 0.08 and 1.01 ± 0.17, respectively There was no significant difference in horizontal width ratio or vertical height ratio before and after surgery ( p = 0.314 and p = 0.087, respectively).

Eyelid reconstruction with a direct closure can be performed without a flap or graft for 40–70% of eyelid defects when resecting the eyelid of a malignant eyelid tumor.