Reconstruction of Full-Thickness Lower Eyelid Defects After BCC Excision Using a Modified Hughes Procedure

Background: Basal cell carcinoma (BCC) is the most common malignant tumor of the eyelid. These cancers often necessitate eyelid reconstruction in ophthalmic plastic surgery, which poses significant challenges. This study describes the use of a tarsoconjunctival flap from the orbicularis oculi muscle of the upper eyelid for reconstructing full-thickness lower eyelid defects following BCC resection. Methods: Four consecutive patients with full-thickness lower eyelid BCC underwent radical resection with 3-mm margins, followed by reconstruction using a tarsoconjunctival flap from the upper eyelid. Digital photographs were taken at baseline and at 1, 3, and 6 months post-surgery to evaluate clinical outcomes. Histological examination confirmed complete tumor excision in all cases. Results: The modified Hughes procedure resulted in a high rate of functional and aesthetic success, with no recurrences observed over an average follow-up of 12 months. None of the patients experienced temporary forced eyelid closure, and both aesthetic and functional results were satisfactory. Conclusions: The tarsoconjunctival flap from the upper eyelid is an effective method for reconstructing extensive full-thickness lower eyelid defects, providing excellent functional and aesthetic outcomes.Background: 基底细胞癌（Basal cell carcinoma, BCC）是最为常见的眼睑恶性肿瘤。此类肿瘤在眼科整形手术中往往需要实施眼睑重建，而该操作面临诸多严峻挑战。本研究介绍了采用取自上眼睑眼轮匝肌（orbicularis oculi muscle）的睑板结膜瓣（tarsoconjunctival flap），修复基底细胞癌切除术后全层下眼睑缺损的术式。 Methods: 连续纳入4例全层下眼睑基底细胞癌患者，均接受3mm安全切缘的根治性切除手术，随后采用上眼睑睑板结膜瓣进行重建。于术前基线状态及术后1、3、6个月拍摄数码照片以评估临床疗效。组织病理学检查证实所有病例均实现肿瘤完整切除。 Results: 改良Hughes手术（modified Hughes procedure）可获得较高的功能与美学修复成功率，平均12个月的随访期间未观察到肿瘤复发。所有患者均未出现暂时性眼睑闭合受限，美学与功能效果均令人满意。 Conclusions: 取自上眼睑的睑板结膜瓣是修复大面积全层下眼睑缺损的有效术式，可获得优异的功能与美学修复效果。