Outcome of tarsoconjunctival flap dehiscence after eyelid reconstruction

Abstract

PURPOSE: To report the outcome of eyelid reconstruction with a tarsoconjunctival flap complicated by premature flap dehiscence. DESIGN: Interventional case series. METHODS: In eight of approximately 100 patients who underwent unilateral lower eyelid reconstruction with a tarsoconjunctival (Hughes) flap during a 15-year interval, the procedure was complicated by premature flap dehiscence resulting from accidental trauma 1 to 11 days after the reconstructive procedure. Immediate surgical repair of the dehiscence was attempted in one case, but the tissues reopened within 1 day. Otherwise, the eyelids were permitted to heal spontaneously with the application of erythromycin ophthalmic ointment as the sole therapy. RESULTS: Although the reconstructed eyelids healed satisfactorily in each case, one patient, who had dry eyes from Sjögren syndrome, required secondary surgery to treat mild lagophthalmos and lower eyelid retraction. CONCLUSIONS: The ultimate functional and esthetic outcomes after premature, traumatic dehiscence of a Hughes flap were generally satisfactory, suggesting that elective division of the conjunctival pedicle in uncomplicated cases may be performed relatively soon after the primary reconstructive procedure.