Secondary tarsoconjunctival flap after previous lower eyelid Hughes repair.
OBJECTIVE
To describe a secondary, two-stage eyelid-sharing tarsoconjunctival flap advancement technique for the repair of full-thickness lower eyelid defect, using the remaining upper eyelid marginal tarsus that was spared in a previously performed Hughes procedure.


METHODS
A computerized database search was performed on all cases of Hughes repair of the lower eyelid performed over a 10-year period (1995 to 2005) to identify patients who required a secondary tarsoconjunctival flap repair. In two cases of tumour recurrence at the lower eyelid margin, an eyelid-sharing, two-stage tarsoconjunctival flap repair of the lower eyelid using the remaining 4 mm of marginal tarsus that was spared in the original Hughes procedure was performed. Case reports of these 2 patients are presented together with their postoperative results.


RESULTS
The incidence rate of the described secondary tarsoconjunctival flap procedure was 2 cases per 240 cases (0.8%) of primary Hughes procedure performed over a 10-year period. The postoperative courses in the 2 patients were uncomplicated with excellent surgical results at 6 months' follow-up.


CONCLUSIONS
The secondary tarsoconjunctival flap advancement procedure is an effective reconstructive technique for the repair of the full-thickness lower eyelid defect in an eyelid that has already undergone a previous Hughes repair.
School of Medical Sciences, University of New South Wales.
John H
JH
Chang
Brett A
BA
O'Donnell
D000368:Aged; D019882:Blepharoplasty / Q000379:methods*; D003228:Conjunctiva / Q000601:surgery*; D005142:Eyelid Neoplasms / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012086:Reoperation; D013524:Surgical Flaps; D017211:Treatment Failure; D014945:Wound Healing