“En-Glove” Lysis of Lower Eyelid Retractors With AlloDerm and Dermis-Fat Grafts in Lower Eyelid Retraction Surgery

Abstract

"En-glove" lower eyelid retraction surgical technique offers a minimally invasive approach for the release of the lower eyelid retractors and allows for volume augmentation using either AlloDerm or dermis-fat spacer graft.

Review of AlloDerm Acellular Human Dermis Regenerative Tissue Matrix in Multiple Types of Oculofacial Plastic and Reconstructive Surgery

“…8 Alloderm has been applied to multiple types of oculoplastic surgery, including posterior lamellar graft in the upper and lower eyelid, lateral canthoplasty, graft in socket reconstruction, middle lamellae scar lysis, volume augmentation in periorbital contour defects, and implant coverage or wrapping material. 6,[9][10][11][12] We used Alloderm as a graft in 76 cases, including lower eyelid posterior lamella elongation or replacement, reconstruction of conjunctival socket and fornix, patch graft on other implant, patch graft on socket after exenteration, releasing periocular scar and repair with Alloderm, and anterior lamella replacement. Alloderm was used as an implant in 27 cases, including releasing orbital rim adhesive scar and repair with Alloderm, periocular soft tissue filler, forehead soft tissue filler, and cheek area soft tissue filler.…”

Lower eyelid retraction repair with resorbable polydioxanone implants

“…In 1977, preserved sclera (autologous graft material) was the first spacer graft used for eyelid reconstruction and has remained the most popular material. [56] Additional materials such as mucosal hard palate and acellular human dermis have been introduced. However, donor site morbidity, difficulty with placement, transmissible diseases, and tissue availability limit the use of all these materials.…”

“…However, donor site morbidity, difficulty with placement, transmissible diseases, and tissue availability limit the use of all these materials. [56] Hence, alloplastic materials serve as a good alternative for space grafts. [56] Different alloplastic materials such as high-density porous polyethylene, polypropylene mesh, and polytetrafluoroethylene have been recently used as a spacer for eyelid reconstruction.…”

A review of combined orbital decompression and lower eyelid recession surgery for lower eyelid retraction in thyroid orbitopathy

“…Spacer material includes autogenous free tarsal graft,13 hard palate mucosal graft,14 dermis fat graft,15 homologous donor sclera16 17 and synthetic material (including Mersilene mesh,18 porous polyethylene19 and Alloderm15) with reported improvements ranging from 1.0 mm15 to 2.38 mm 16. Complications are wide ranging and involve the donor or recipient site, with rates varying from 17.5%14 to 49%19 depending on the material used.…”