Early division of the conjunctival pedicle in modified Hughes repair of the lower eyelid.

BACKGROUND AND OBJECTIVE: The modified Hughes repair of the lower eyelid (upper lid tarsoconjunctival flap and skin graft or flap) after resection of marginal lesions has an established place in oculoplastic surgery. Previous recommendations for the timing of the division of the conjunctival pedicle have varied greatly from 3 weeks to 6 months. This study was performed to determine the safety of division of the pedicle at 2 weeks.

PATIENTS AND METHODS: A series of 25 patients in whom the tarsoconjunctival pedicle in a modified Hughes repair of the lower eyelid was divided at 2 weeks were prospectively evaluated. All cases had a full-thickness skin graft placed as an anterior lamella of the reconstructed eyelid.

RESULTS: In all cases there was a healthy and viable lower lid with brisk bleeding from the newly created lid margin at the time of pedicle division. There were no instances of infarction of any portion of the reconstruction, shrinkage, or retraction of the lower lid.

CONCLUSION: Two weeks is a long enough time to wait prior to division of the conjunctival pedicle in the modified Hughes repair of the lower eyelid.