{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:08:00Z","timestamp":1788962880370,"version":"build-2803163510"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Summary:<\/jats:title>\n                    <jats:p>Reconstruction of large full-thickness medial lower eyelid margin defects often requires centrally based tarsoconjunctival pedicle flaps from the ipsilateral upper eyelid in combination with anterior lamellar grafting. However, centrally based flaps may result in temporary obstruction of the visual axis in the affected eye. The authors present a novel modified surgical technique using a medially based tarsoconjunctival pedicle flap from the upper eyelid for the reconstruction of large full-thickness medial lower eyelid defects. A tarsoconjunctival flap was mobilized and hinged medially by the conjunctiva from the upper eyelid with rotation into the lower eyelid defect. This surgical technique was used in 4 cases of medial lower eyelid defects involving 60% to 65% of the eyelid after basal cell carcinoma excision. Successful reconstruction of the defect was achieved in all 4 cases without graft failure, wound dehiscence, or lagophthalmos. Medially hinged tarsoconjunctival pedicle flaps are an effective technique for the reconstruction of large full-thickness medial lower eyelid defects. This procedure may be considered especially in patients with similar defects who cannot tolerate ocular occlusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/prs.0000000000012425","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T17:00:37Z","timestamp":1757350837000},"page":"138e-141e","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Reconstruction of Large Full-Thickness Medial Lower Eyelid Defects Using a Medially Based Tarsoconjunctival Pedicle Flap"],"prefix":"10.1097","volume":"158","author":[{"given":"Zvi","family":"Gur","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem"},{"name":"Division of Oculofacial Plastic and Reconstructive Surgery, Viterbi Family Department of Ophthalmology, University of California, San Diego, Shiley Eye Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marissa K.","family":"Shoji","sequence":"additional","affiliation":[{"name":"Division of Oculofacial Plastic and Reconstructive Surgery, Viterbi Family Department of Ophthalmology, University of California, San Diego, Shiley Eye Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahia","family":"Dib El Jalbout","sequence":"additional","affiliation":[{"name":"Division of Oculofacial Plastic and Reconstructive Surgery, Viterbi Family Department of Ophthalmology, University of California, San Diego, Shiley Eye Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine Y.","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Oculofacial Plastic and Reconstructive Surgery, Viterbi Family Department of Ophthalmology, University of California, San Diego, Shiley Eye Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bobby S.","family":"Korn","sequence":"additional","affiliation":[{"name":"Division of Oculofacial Plastic and Reconstructive Surgery, Viterbi Family Department of Ophthalmology, University of California, San Diego, Shiley Eye Institute"},{"name":"Division of Plastic Surgery, Department of Surgery, University of California, San Diego, School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Don O.","family":"Kikkawa","sequence":"additional","affiliation":[{"name":"Division of Oculofacial Plastic and Reconstructive Surgery, Viterbi Family Department of Ophthalmology, University of California, San Diego, Shiley Eye Institute"},{"name":"Division of Plastic Surgery, Department of Surgery, University of California, San Diego, School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,3]]},"reference":[{"key":"R1-20260730","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1097\/IOP.0000000000000598","article-title":"Evaluation of the microvascular blood flow, oxygenation, and survival of tarsoconjunctival flaps following the modified Hughes procedure.","volume":"32","author":"Memarzadeh","year":"2016","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"R2-20260730","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s40001-016-0221-1","article-title":"Modified Hughes procedure for reconstruction of large full-thickness lower eyelid defects following tumor resection.","volume":"21","author":"Hishmi","year":"2016","journal-title":"Eur J Med Res"},{"key":"R3-20260730","first-page":"321","article-title":"Total lower lid reconstruction: technical details.","volume":"74","author":"Hughes","year":"1976","journal-title":"Trans 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Surg"},{"key":"R7-20260730","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1055\/s-0028-1095889","article-title":"Reconstruction of the eyelids after Mohs surgery.","volume":"22","author":"Ahmad","year":"2008","journal-title":"Semin Plast Surg"},{"key":"R8-20260730","first-page":"3350","article-title":"Repair of the lower eyelid with the versatile bucket handle flap.","volume":"62","author":"Brundridge","year":"2021","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"R9-20260730","doi-asserted-by":"crossref","first-page":"e325","DOI":"10.1097\/SCS.0000000000010006","article-title":"Reconstruction of full-thickness eyelid defects following tumor resection: the bucket handle modification.","volume":"35","author":"Gur","year":"2024","journal-title":"J Craniofac Surg"},{"key":"R10-20260730","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1016\/0002-9394(76)90311-1","article-title":"Lower eyelid reconstruction by tarsal transposition.","volume":"81","author":"Hewes","year":"1976","journal-title":"Am J Ophthalmol"},{"key":"R11-20260730","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1097\/00002341-198906000-00004","article-title":"Bipedicle tarsoconjunctival flap.","volume":"5","author":"Hargiss","year":"1989","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"R12-20260730","doi-asserted-by":"crossref","first-page":"1825","DOI":"10.2147\/OPTH.S115540","article-title":"Longevity results of modified Hughes procedure in reconstructing large lower eyelid defects.","volume":"10","author":"Zaky","year":"2016","journal-title":"Clin Ophthalmol"}],"container-title":["Plastic &amp; Reconstructive 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