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Tarsal-Conjunctival Advancement Flap in Lower Eyelid Reconstruction

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Manual of Oculoplastic Surgery

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Abstract

The tarsal-conjunctival flap is a versatile technique with many advantages for repairing large lower eyelid defects. It is fairly straightforward from a technical standpoint and takes less operative time than major flaps and free grafts. Since its introduction in the early twentieth century, several modifications have improved upon the major complications, including upper lid retraction, upper lid entropion, and eyelid margin erythema. This chapter discusses the main principles of eyelid reconstruction, the algorithm for repairing lower eyelid defects, and the step-by-step manual for performing the tarsal-conjunctival flap.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA

    Viraj J. Mehta

  2. Department of Ophthalmology, Vanderbilt University Medical Center, Nashville, TN, USA

    Rachel K. Sobel

Authors
  1. Viraj J. Mehta
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  2. Rachel K. Sobel
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Corresponding author

Correspondence to Rachel K. Sobel .

Editor information

Editors and Affiliations

  1. Case Western Reserve University School of Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA

    Mark R. Levine

  2. Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA

    Richard C. Allen

Electronic Supplementary Material

Video 37.1

Hughes flap (tarsal-conjunctival flap). Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/1/Hughes-Flap.htm (MP4 242223 kb)

Video 37.2

Hughes flap with skin graft. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/8/10-Hughes-flap-w-skin-graft.htm (MP4 193850 kb)

Video 37.3

Second stage Hughes flap. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/1/second-stage-hughes-flap.htm (MP4 77100 kb)

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Mehta, V.J., Sobel, R.K. (2018). Tarsal-Conjunctival Advancement Flap in Lower Eyelid Reconstruction. In: Levine, M., Allen, R. (eds) Manual of Oculoplastic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-74512-1_37

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  • DOI: https://doi.org/10.1007/978-3-319-74512-1_37

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-74511-4

  • Online ISBN: 978-3-319-74512-1

  • eBook Packages: MedicineMedicine (R0)

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