The evolution of the Hughes tarsoconjunctival flap for the lower eyelid reconstruction

The Hughes tarsoconjunctival flap was initially described in 1937. This flap is best used for reconstructing full-thickness defects involving the central portion of the lower eyelid. The evolution of this flap over the last 60 years is outlined. Several important modifications are presented; these modifications lead to decreased donor-site morbidity and improved recipient site outcome.