Tarsal kinking after Hughes flap

A retrospective review of 45 patients undergoing the Hughes tarsoconjuctival flap procedure for lower eyelid reconstruction detected three individuals who developed kinking of the tarsus and upper eyelid margin. This unusual complication became apparent at the time of flap division. A horizontal band of fibrosis at the superior border of the remaining upper eyelid tarsus was appreciated in two of the patients. Excision of the fibrotic tissue resulted in an immediate improvement of the deformity.