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This is a retrospective case series looking at the use of Hughes flap for cicatricial lower lid retraction. Fourteen patients were identified across five different hospitals with varying aetiologies ranging from previous lid lesion excision and reconstruction to trauma. The anterior lamellar was reconstructed with a skin graft in 50% of patients, and in the other 50% a flap was used. Hughes flap division occurred between six days and 2.5 years. Complications included persistent lagophthlamos and exposure keratopathy, consecutive upper lid retraction, wound dehiscence, and further lid retraction following flap division. The heterogenous nature of the cohort of patients make it difficult to draw conclusions on the benefit of this technique, although the authors describe having mostly excellent outcomes. It would be advantageous, in future, to compare this technique with others for lower lid retraction to determine its success.

Hughes flap in the management of lower lid retraction.
Juniat V, Ryan T, O’Rourke M, et al.
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Hetvi Bhatt

Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.

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