January 18, 2014
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Novel approach: Use Hughes flap for lid malposition

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KOLOA, Hawaii – A speaker discussed the concept of using a common lid defect procedure for lid malposition here at the Hawaiian Eye meeting.

Jeremiah Tao, MD, FACS, of The Gavin Herbert Eye Institute at the University of California, Irvine, described the Hughes flap procedure as his “go-to for a paralyzed lid” after answering the question “Is there a way we can create suspenders for the eyelids?”

Jeremiah Tao

Tao said there have been previous descriptions in the literature of torsal pillars and pillar flaps. And while the results were reasonable, “they didn’t look good,” he said.

Tao said he and his colleagues’ study of hundreds of patients will look at the suspender procedure for paralytic eyelid malposition – a topic not previously discussed in the literature.

He said the procedure which uses the backside of the upper portion of the upper eyelid to recreate a full thickness defect in the lower eyelid, which places the Hughes flap as laterally as possible, tightens the flap and then attaches it to the lower lid, can be used with or without a lateral canthoplasty. –by Joan-Marie Stiglich

Disclosure: Tao has no relevant financial disclosures.