Abstract

Eyelids play an important role in protecting the globe. Defects in the eyelids can occur as part of congenital anomalies, surgical resection of tumors or traumatic injuries. A thorough knowledge of the eyelid anatomy can help in eyelid reconstruction that can provide gratifying results.Extensive upper eyelid defects have been repaired traditionally by Cutler-Beard procedure, which is a full thickness advancement bridge flap. Hughes flap is a tarsoconjunctival flap traditionally used for repairing lower eyelid defects. However, a modified technique called reverse Hughes procedure can be utilized and can have certain advantages over the traditional Cutler-Beard procedure for adequately reconstructing extensive upper eyelid defect giving the advantage of a good tarsal support to the eyelid. This video illustrates pearls in the management of eyelid defects and reconstruction describing in detail modified reverse Hughes tarsoconjunctival flap.