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All Journal Indonesian Journal of Urology JURNAL KESEHATAN INDRA HUSADA Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research Ophthalmologica Indonesiana
Hendriati
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Other

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Modified Hughes Tarsoconjunctival Flap Procedure for Lower Eyelid Defect: A Case Series Aulia; Hendriati
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 3 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i3.1226

Abstract

Background: The Hughes procedure, or tarsoconjunctival flap, is a technique used in reconstructing full-thickness lower eyelid defects involving >50% of the eyelid margin to restore anatomical integrity, function, and cosmesis of the eyelid. The modified Hughes procedure spares the marginal upper lid tarsus and removes the levator muscle aponeurosis from the tarsoconjunctival flap. This study reports a case series of patients who underwent a modified Hughes procedure after basal cell carcinoma excision. Case presentation: Two patients underwent lower eyelid reconstruction using the modified Hughes procedure. After a wide excision of the tumor, a tarsoconjunctival flap was created to reconstruct the posterior lamella of the eyelid. Subsequently, the anterior lamella of the eyelid was reconstructed using a full-thickness skin graft and an advancement flap, respectively. Both patients underwent a second surgery, tarsus flap release, 6-8 weeks after the first surgery. Postoperatively, tarsal flap apposition, skin flap/graft, and stitches were intact. After the tarsus flap release, wound healing was good. A tumor biopsy showed basal cell carcinoma. Conclusion: The modified Hughes procedure is a treatment of choice in reconstructing full-thickness lower eyelid defects involving >50% of the eyelid margin. Full-thickness skin graft and advancement flap to reconstruct the anterior lamella of the eyelid are chosen after considering skin color, texture similarity, and the laxity of the eyelid and cheek.
Co-Authors Andrini Ariesti Ariesti Andrini Ariesti, Andrini Aulia Aulia Achmad, Baraz Chaerena Amri Citra Manela Delvi Saswita ERINA, RIKHA Etriyel Myh Fortuna, Fory Harlin Farhani Helvinda Weni Hidayat Muhammad Iffah Annadiyah Ilahi, Fitratul Irayanti Julita Kemala Sayuti lonanda, Gama Agusto Lucyana Mandela, Kelvin Mardijas Efendi Muhammad Hidayat Pattih Primasakti Pratama Yogi Rani Apriani Rinal Effendi Rino Agustian Praja Vitresia, Havriza Wati Rinda Weni Helvinda Yolanda Wulandari Erwen Zulfiqar, Yevri