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Updated: Aug 12, 2026
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Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Single tarsoconjunctival flap (lower eyelid) for upper eyelid reconstruction ("reverse" modified Hughes procedure)
1Department of Ophthalmology, UMD-New Jersey Medical School, Newark.
Ophthalmic Surgery
|June 1, 1994
Summary
This study introduces a novel two-stage surgical technique for upper eyelid defect reconstruction, offering enhanced stability and fewer complications than traditional methods.
Area of Science:
- Ophthalmology
- Plastic Surgery
- Reconstructive Surgery
Background:
- Upper eyelid defects require specialized reconstructive techniques.
- Existing methods like the Cutler-Beard procedure have known complications.
Purpose of the Study:
- To present a novel two-stage surgical reconstruction for full-thickness upper eyelid defects.
- To evaluate the efficacy and safety of this new technique compared to alternatives.
Main Methods:
- A two-stage approach using a lower eyelid tarsoconjunctival flap for the posterior lamella and a skin graft for the anterior lamella.
- The flap is severed 5-8 weeks post-surgery.
- This technique is termed a "reverse" modified Hughes procedure.
Main Results:
- The procedure offers greater stability due to increased vertical tarsus.
- It allows for a closer incision to the lower eyelid margin, preserving the marginal artery.
- Complications included pyogenic granuloma and mild blepharoptosis; no cicatricial entropion occurred.
Conclusions:
- The described "reverse" modified Hughes procedure is a stable and effective method for upper eyelid reconstruction.
- It presents a favorable alternative to the Cutler-Beard procedure, with a reduced risk of cicatricial entropion.
