Outcomes of Hughes flap in lower eyelid reconstruction
Reviewed by Jaya Myneni

One hundred and 22 consecutive patients who underwent tarsoconjunctival advancement flap surgery for lower eyelid defects were part of this study. Ninety percent of them had lesion excision using Mohs micrographic surgery. Eighty percent of these were for basal cell carcinomas. Mean age of study population was 71 years with a male preponderance (56%). Mean flap width for reconstruction was larger for male (10mm) than for female patients (8.76mm), suggesting that men present with advanced disease. A mean of 1.7 additional adjuvant reconstructive procedures was required in each case. Mean follow-up was seven months. Mean duration to flap division was 37 days, but reduced considerably over the course of the study and a majority of cases with division at less than three weeks were uncomplicated. Postoperative cosmetic appearance was satisfactory in 91% of patients. Fourteen percent (n=17) of patients had complications, with five requiring surgical revision. Patients with significantly shorter duration to flap division developed lid retraction. There was no statistical difference between flap width and complications. The study suggests that this method of reconstruction is useful in a range of eyelid defects with good functional and cosmetic outcomes. 

Eyelid reconstruction using the ‘’Hughes’’ tarsoconjunctival advancement flap: Long-term outcomes in 122 consecutive cases over a 13-year period.
McKelvie J, Ferguson R, Ng SGJ.
ORBIT
2017;36(4):228-33.