Igal Leibovitch1, Dinesh Selva. 1. Oculoplastic & Orbital Unit, Department of Ophthalmology, Royal Adelaide Hospital, University of Adelaide, Adelaide, Australia.
Abstract
PURPOSE: To report the outcome of early division of the tarsoconjunctival pedicle of a modified Hughes flap at 1 week after the primary operation. DESIGN: Noncomparative, interventional, prospective case series. PARTICIPANTS: Twenty-nine eyelids of 29 consecutive patients operated using the modified Hughes flap and full-thickness skin graft for lower eyelid reconstruction after Mohs micrographic surgery, over a 4-year period. INTERVENTION: In all patients, the pedicle of the Hughes flap was divided 1 week after the primary operation. MAIN OUTCOME MEASURES: Postoperative lower eyelid flap viability and lower eyelid contour complications. RESULTS: Twenty-nine eyelids of 29 patients (mean age: 69+/-11 years) were operated using the modified Hughes flap. The mean follow-up period was 14+/-6 months (range: 6-23). There were no cases of lower eyelid retraction, flap ischemia, or necrosis after division. Postoperative complications included lower eyelid margin erythema in 2 patients (6.9%), upper eyelid lash ptosis in 3 patients (10.3%), and upper eyelid lateral retraction in 1 patient (3.4%). CONCLUSION: Early division of the tarsoconjunctival pedicle of a modified Hughes flap at 1 week does not compromise the viability of the reconstructed lower eyelid and results in a good functional and cosmetic outcome.
PURPOSE: To report the outcome of early division of the tarsoconjunctival pedicle of a modified Hughes flap at 1 week after the primary operation. DESIGN: Noncomparative, interventional, prospective case series. PARTICIPANTS: Twenty-nine eyelids of 29 consecutive patients operated using the modified Hughes flap and full-thickness skin graft for lower eyelid reconstruction after Mohs micrographic surgery, over a 4-year period. INTERVENTION: In all patients, the pedicle of the Hughes flap was divided 1 week after the primary operation. MAIN OUTCOME MEASURES: Postoperative lower eyelid flap viability and lower eyelid contour complications. RESULTS: Twenty-nine eyelids of 29 patients (mean age: 69+/-11 years) were operated using the modified Hughes flap. The mean follow-up period was 14+/-6 months (range: 6-23). There were no cases of lower eyelid retraction, flap ischemia, or necrosis after division. Postoperative complications included lower eyelid margin erythema in 2 patients (6.9%), upper eyelid lash ptosis in 3 patients (10.3%), and upper eyelid lateral retraction in 1 patient (3.4%). CONCLUSION: Early division of the tarsoconjunctival pedicle of a modified Hughes flap at 1 week does not compromise the viability of the reconstructed lower eyelid and results in a good functional and cosmetic outcome.
Authors: Ahmed M Hishmi; Konrad R Koch; Mario Matthaei; Edwin Bölke; Claus Cursiefen; Ludwig M Heindl Journal: Eur J Med Res Date: 2016-06-30 Impact factor: 2.175