Postoperative Eyelid Pyogenic Granuloma: A Systematic Review of Clinical Features, Surgical Associations, and Management.

Pyogenic granuloma (lobular capillary haemangioma) is a benign vascular lesion that may arise following trauma, inflammation, or surgery. In oculoplastic practice, it represents a recognised but likely underreported postoperative complication. We present a case of recurrent pyogenic granuloma arising from a posterior lamellar defect following eyelid reconstruction using a Hughes flap, highlighting key clinical features and management considerations. A systematic review of the literature was also performed to contextualise this case, identifying 14 studies comprising 498 cases. Lesions typically presented within weeks of surgery as rapidly growing, friable, pedunculated masses arising at sites of surgical disruption. While topical therapies such as corticosteroids and timolol may be effective in selected cases, surgical excision remains the most reliable treatment and allows histological confirmation. This case and systematic review support the theory that postoperative pyogenic granuloma represents a manifestation of dysregulated wound healing driven by aberrant angiogenesis at sites of epithelial disruption.