This video presents a case of a whole full-thickness defect of the lower eyelid reconstructed with the Hughes procedure. This technique recreates the posterior lamella of the lower eyelid through use of a tarsoconjunctival flap from the upper eyelid. At least 4mm of tarsus is preserved proximal to the lid margin for lid stability and to prevent the complication of upper lid entropion. The tarsoconjunctival flap is advanced into the defect of the lower eyelid and secured with a medial and lateral periosteal flaps. A laterally based myocutaneous transposition flap from the upper eyelid (Tripier flap) reconstructs the anterior lamella. The Hughes flap is left in place for 2-3weeks before separation.
12 March 2017