Modified second stage Hughes tarsoconjunctival reconstruction for lower eyelid defects

Area of Science:

• Ophthalmology
• Plastic Surgery
• Regenerative Medicine

Background:

• The modified Hughes procedure is a common technique for lower eyelid reconstruction.
• Hyperemic, hypertrophic conjunctival margins with discharge can complicate lower eyelid reconstruction.
• Amniotic membrane grafts (AMTs) have shown potential in ocular surface reconstruction.

Purpose of the Study:

• To describe a novel technique using AMT in modified Hughes eyelid reconstruction.
• To evaluate the efficacy of AMT in preventing or revising hyperemic, hypertrophic conjunctival margins.
• To assess complications associated with this modified reconstruction technique.

Main Methods:

• A retrospective, non-comparative interventional study.
• Thirty patients underwent modified Hughes reconstruction with AMT added to the mucocutaneous junction.
• Data collected included post-Mohs defect size and post-reconstruction complications.

Main Results:

• The mean post-Mohs defect size was significant, involving a large percentage of the lower eyelid.
• No hyperemic or hypertrophic margins or excessive discharge were observed at follow-up.
• One patient received AMT for revision, while 29 received it as a primary preventative procedure.

Conclusions:

• The addition of AMT to modified Hughes lower eyelid reconstruction is a promising technique.
• AMT appears effective in preventing and revising problematic conjunctival margins.
• Larger studies with longer follow-up are needed to confirm these preliminary findings.