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
- EP ID EP292802
- DOI 10.18231/2455-8478.2017.0044
- Views 63
- Downloads 0
Orbital inflammation caused by bisphosphonates case report and literature review
Bisphosphonates are drugs broadly disseminated and frequently used in clinical practice. Ocular adverse effects are already known and orbital inflammation outstands as one of the most severe. It is clinically evident by...
A case report on Muir -Torre syndrome in a male with colon cancer and sebaceous carcinoma of right upper lid
Introduction: Muir-Torre syndrome (MTS) is a rare, autosomal dominant, genetic condition characterised by occurrence of sebaceous tumors and visceral malignancies. The most common visceral malignancy associated with Muir...
Orbital measurements in patients with non-syndromic craniosynostosis
Context: Congenital craniofacial anomalies are a rare group of disease. Diagnosis and treatment of this condition is important as the patients develop a series of complications affecting their neurological, visual and s...
Optic disc drusens mimicking papilloedema
Optic disc drusens and papilledema have similar fundus presentation leading to confusion between the twoCase Report Here we present a case of 12 years old male who presented with complaints of headache since 1 year assoc...
Multimodal strategic approach in the clinical assessment of malingering – keeping an eye on truth!!!
Purpose To evaluate patients who present with ophthalmic problems with no discernible organic cause and detect malingering in such casesMaterials and Methods 175 patients reporting to the Ophthalmology outpatient departm...