Juniat Valerie, Ryan Tess, O'Rourke Michael, Ng Sgj, O'Donnell Brett, McNab Alan A, Selva Dinesh
Discipline of Ophthalmology and Visual Science, University of Adelaide, Adelaide, Australia.
Department of Ophthalmology, Royal Adelaide Hospital and South Australian Institute of Ophthalmology, Adelaide, Australia.
Orbit. 2022 Dec;41(6):733-738. doi: 10.1080/01676830.2021.2006721. Epub 2021 Dec 23.
We present a retrospective case series on the use of Hughes flap in managing acquired cicatricial lower lid retraction.
This was a multicentre, retrospective case series. Data was collected from medical records across different sites within Australia (Adelaide, Melbourne, and Sydney) and New Zealand (Hamilton).
Fourteen patients were identified. The aetiology of cicatricial lower lid retraction included previous lid lesion excision and reconstruction, eyelid trauma, orbital fracture repair, orbital radiotherapy, and lateral canthal dystopia from previous lid surgeries. 4/14 (29%) cases had undergone other surgery to correct the retraction prior to the Hughes flap. Pre-operative lagophthalmos due to lower lid retraction was noted in 11/14 (79%) cases with a median 2 mm (range: 1-5 mm). Exposure keratopathy was present in 7/14 (50%) cases. There were no peri-operative complications during Hughes flap reconstruction. One patient had post-operative upper eyelid retraction that did not require any further intervention. One patient had persistent lagophthalmos and exposure keratopathy that is being managed conservatively. One patient had wound dehiscence and further lid retraction following flap division, which required further surgery. Median length of follow-up was 15 months (range: 0.5-84 months). At final review, improvement or resolution of symptoms was seen in 13/14 (93%) cases.
A Hughes flap is an effective surgical technique for the management of cicatricial lower lid retraction.
我们呈现一组关于使用休斯皮瓣治疗后天性瘢痕性下睑退缩的回顾性病例系列。
这是一个多中心回顾性病例系列。数据收集自澳大利亚（阿德莱德、墨尔本和悉尼）及新西兰（汉密尔顿）不同地点的医疗记录。
共确定了14例患者。瘢痕性下睑退缩的病因包括既往睑部病变切除与重建、眼睑外伤、眼眶骨折修复、眼眶放疗以及既往睑部手术导致的外眦移位。14例中有4例（29%）在进行休斯皮瓣手术前已接受其他矫正退缩的手术。14例中有11例（79%）因下睑退缩出现术前兔眼，退缩中位数为2毫米（范围：1 - 5毫米）。14例中有7例（50%）存在暴露性角膜病变。休斯皮瓣重建术中无围手术期并发症。1例患者术后出现上睑退缩，但无需进一步干预。1例患者持续存在兔眼和暴露性角膜病变，目前采用保守治疗。1例患者在皮瓣分离后出现伤口裂开和进一步的睑退缩，需要再次手术。中位随访时间为15个月（范围：0.5 - 84个月）。在最后一次复查时，14例中有13例（93%）症状得到改善或缓解。
休斯皮瓣是治疗瘢痕性下睑退缩的一种有效手术技术。
