Purpose: To report the outcome of early division of the tarsoconjunctival pedicle of a modified Hughes flap at 1 week after the primary operation.
Design: Noncomparative, interventional, prospective case series.
Participants: Twenty-nine eyelids of 29 consecutive patients operated using the modified Hughes flap and full-thickness skin graft for lower eyelid reconstruction after Mohs micrographic surgery, over a 4-year period.
Intervention: In all patients, the pedicle of the Hughes flap was divided 1 week after the primary operation.
Main outcome measures: Postoperative lower eyelid flap viability and lower eyelid contour complications.
Results: Twenty-nine eyelids of 29 patients (mean age: 69+/-11 years) were operated using the modified Hughes flap. The mean follow-up period was 14+/-6 months (range: 6-23). There were no cases of lower eyelid retraction, flap ischemia, or necrosis after division. Postoperative complications included lower eyelid margin erythema in 2 patients (6.9%), upper eyelid lash ptosis in 3 patients (10.3%), and upper eyelid lateral retraction in 1 patient (3.4%).
Conclusion: Early division of the tarsoconjunctival pedicle of a modified Hughes flap at 1 week does not compromise the viability of the reconstructed lower eyelid and results in a good functional and cosmetic outcome.