Partial spontaneous cross union post-division of hughes flap

We report three cases of partial spontaneous canthal cross union, a rare complication in cases where Hughes flaps are used to reconstruct lower eyelid defects that also involve the canthi. All cases of spontaneous cross union were identified within 2 months of uneventful division of Hughes' flap. Two cases were successfully divided with good aesthetic results although one patient was not keen on surgery, as it was aesthetically acceptable to him. The postulated mechanism was either the proximity of the divided nonepithelial margins or the failure to trim the residual upper eyelid tarsoconjunctival remnant. We recommended adequate trimming of the residual upper eyelid tarsoconjunctival remnant and an early postoperative review to prevent adhesions from developing.