Outcome of the Modified Hughes Procedure for Eyelid Sebaceous Carcinoma.

Abstract

Purpose: To report the outcomes of reconstruction of eyelids by modified Hughes method in patients with sebaceous carcinoma of the eyelid. Method: Nineteen patients were diagnosed as having sebaceous carcinoma in the Department of Ophthalmology, Tokyo medical University from 2009 through 2013. Tumors were resected and eyelids were reconstructed by the modified Hughes method. We retrospectively evaluated the patients' background and outcome of the surgery. Results: Average age of the patients was 71 years old, and average follow up period after surgery was 24 months. Average size of the tumor was 10.2 mm in upper eyelid and 7.8 mm in lower eyelid. After resection of the tumor, the defect of the eyelid was reconstructed by tarsoconjunctival flap (Hughes flap) and by stretching the surrounding eyelid skin. Pedicle was divided at an average of 33 days after surgery. Post-operative complications included mild entropion in 3 patients, ectropion in 3 patients, superficial punctate keratitis in 3 patients, and 1 ptosis that required surgical repair. One patient who showed local recurrence of the tumor underwent extended resection and reconstruction of the eyelid. Conclusion: The modified Hughes method is effective for reconstruction of the resected eyelids with sebaceous carcinoma. Especially, postoperative complications of the ocular surface tend to be limited.