Outcome of tarsoconjunctival flap dehiscence after eyelid reconstruction.

Abstract

To report the outcome of eyelid reconstruction with a tarsoconjunctival flap complicated by premature flap dehiscence. Interventional case series. 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. 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. 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.