Normal lid margin after eyelid reconstruction.
To prevent corneal damage, the central lid margin must have a normal skin-conjunctiva interface following the lid reconstruction. A two-step procedure may be employed: In the lower lid an initial Hughes reconstruction should be tried. If this is unacceptable, a subsequent block excision of the segment is performed. The important step in both phases is a thorough lateral cantholysis. In the upper lid, the central defect is immediately reconstructed by sliding the lateral lid remnant to the medial remnant. The resulting lateral defect is reconstructed with a Hughes procedure. In both cases, a physiologic lid margin is insured, because normal lid is sutured to normal lid.
D003228:Conjunctiva / Q000601:surgery; D062109:Dermatologic Surgical Procedures; D005143:Eyelids / Q000601:surgery*; D006801:Humans; D008722:Methods