Repair of large full thickness lower lid defect following mass excision using Modified Hughes procedure

Journal Title: IP International Journal of Ocular Oncology and Oculoplasty - Year 2017, Vol 3, Issue 2

Abstract

Objective: To highlight a case of lower lid repair using Hughes procedure. Case Report: 70 year old male presented with painless, firm looking growth on left lower eyelid for 2 years. A pentagonal shaped lid excision done involving whole extent of the mass along with 2 mm of surrounding healthy looking tissue. Large posterior laminar horizontal defect was repaired with a Hughes tarsoconjunctival flap prepared by undermining the tarsus and conjunctiva upto the levator aponeuros in superior fornix and inferiorly leaving at least 4 mm of tarsus for lid stability. This bridge flap was advanced to the lower lid defect and sutured to the remnants of tarsus of lower lid to form posterior lamella. Anterior lamella was repaired with an appropriately sized full thickness skin graft taken from upper lid. A second stage surgery was done after 6 weeks to excise the bridge. With the help of a grooved director, which was slid underneath the flap anterior to the cornea, the flap was divided using a blade. Conjunctiva sutured to the lower eyelid margin. Results: Post op showed excellent graft uptake. During follow up visits there were good lid movements, no exposure keratitis. There was no lid retraction or lagophthalmos. Conclusion: This case highlights that management for a large lid defect using Hughes Procedure gives a successful outcome in terms of graft uptake and stability. Anterior lamella repaired from upper eyelid skin gives superior results as it is easily available and matches the host site in color and skin characteristics

Authors and Affiliations

Gopal K. Das, Pramod K. Sahu, Divya Jain, Sabitabh Kumar, Priyanka Dahiya

Keywords

Related Articles

Upper lid dermatochalasis and transcutaneous blepharoplasty

Redundant and lax eyelid skin and muscle is known as dermatochalasis. It is a degenerative disease of skin and muscles of lids and is commonly seen in elderly persons and occasionally in young adults. Gravity, loss of el...

Eye lid trauma and their management

Purpose: To study the various mode and site of lid injuries and to evaluate the results of immediate surgery, delayed surgery, and surgery on infected cases. Method: This is the prospective study conducted in ophthalmolo...

A retrospective study of pterygium cases treated in a tertiary care hospital at Puducherry

Introduction: Pterygium is a fibrovascular outgrowth of the conjunctiva occur due to the exposure of eyes to UV irradiation, heat and dust causes. There are different surgical procedures available for the management of p...

Congenital ptosis - A clinical and demographic study in a tertiary eye care hospital

Aim To study the clinical and demographic characteristics of Congenital Ptosis at a tertiary eye care centreMaterial and Methods This is a retrospective study of patients admitted for surgical correction of ptosis under...

Unilateral intra-orbital pseudo tumor in infant- a rare entity with review of literature

"Pseudo tumor" is an idiopathic orbital inflammatory disease characterized by non-specific inflammation involving the orbit. This condition being non-infectious, and non-neoplastic disease with unknown etiology. After th...

Download PDF file
  • EP ID EP292802
  • DOI 10.18231/2455-8478.2017.0044
  • Views 65
  • Downloads 0

How To Cite

Gopal K. Das, Pramod K. Sahu, Divya Jain, Sabitabh Kumar, Priyanka Dahiya (2017). Repair of large full thickness lower lid defect following mass excision using Modified Hughes procedure. IP International Journal of Ocular Oncology and Oculoplasty, 3(2), 156-159. https://europub.co.uk/articles/-A-292802