Comparative evaluation of conventional and modified Hughes procedures in reconstructing large full-thickness defects of the lower eyelid

To introduce a modified Hughes procedure for the repair of large full-thickness defects of the lower eyelid. This retrospective study included 56 patients: 30 in the conventional group treated with a Hughes flap and 26 in the modified group treated with a full-thickness upper eyelid flap pedicled with levator aponeurosis, Muller muscle and conjunctiva. The reconstruction time, period of pedicle division and complication rates were evaluated. The lower eyelid reconstruction time was 89.2±7.7 minutes in the conventional group and 61.7±7.5 minutes in the modified group, whereas the period of pedicle division was 21.1±3.0 days in the conventional group and 10.8±3.0 days in the modified group, and the differences were statistically significant (p = 0.000 and 0.000). Lower eyelid retraction was 0.4±0.4 mm in the conventional group and 0.1±0.2 mm in the modified group, and the difference was statistically significant (p = 0.001). The modified Hughes procedure in this study resulted in a shorter lower eyelid reconstruction time, a shorter period of pedicle division, and a lower degree of lower eyelid retraction. This technique is simple and convenient for reconstructing large full-thickness defects of the lower eyelid.