Dr.ANKIT SINGH TOMAR, Dr.Santosh G Honavar
The definitive treatment for eyelid malignancies is surgical excision with clear margins. The challenge lies at reconstruction of the acquired coloboma while aiming to achieve acceptable cosmesis and functionality. Hughes’ procedure has stood the test of time as a method to reconstruct full thickness lower eyelid defects.
Reconstruction of the large acquired coloboma involves a two staged Hughes’ procedure. First stage consists of formation of tarsoconjunctival flap from the upper eyelid for the posterior lamina, along with vertical sliding flap of skin-orbicularis from the surrounding peri-ocular area for the reconstruction of the anterior lamina of lower eyelid. Six weeks post first surgery, the second stage is carried out and it includes separation of lower and upper eyelid to achieve normal anatomical architecture and cosmesis. This video gives a clear conceptual approach to Hughes’ procedure for reconstruction of a lower eyelid coloboma.
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