Treatment of Lower Eyelid Retraction by Retractor Release and Posterior Lamellar Grafting: An Analysis of 659 Eyelids in 400 Patients

Abstract

Lower eyelid retraction repair with posterior lamellar grafting and lateral eyelid tightening can be recommended with confidence for eyelid retraction patients because most improved subjectively and by objective examination.

Porcine Dermal Collagen in Lower Eyelid Retraction Repair

“…A mean reduction in lagophthalmos, superficial punctate keratopathy, and scleral show was demonstrated for all etiology groups and graft types included in the study. 74 Similarly, Patel et al 23 retrospectively reviewed the outcomes of 17 patients who underwent hard palate spacer grafting, lateral canthal suspension, and midface elevation for repair of lower eyelid retraction. All 17 patients had complete resolution of scleral show and preoperative dry eye symptoms.…”

“…46 Additionally, only minimal shrinkage has been reported in most cases, with the greatest resistance to shrinkage seen in thinner grafts. 46,48,72,73 Oestreicher et al 74 compared the outcomes of posterior lamellar grafting with sclera, tarsoconjunctival, and hard palate mucosa in lower eyelid retraction repair. A mean reduction in lagophthalmos, superficial punctate keratopathy, and scleral show was demonstrated for all etiology groups and graft types included in the study.…”

Composite Septo-Retractor Recession; A Surgical Technique for Lower-Eyelid Retraction and Review of the Literature

“…Reported complications include sensory loss, hemorrhage, oral infection, pain, oro-nasal fistula and keratinization. 4,13,14,29,30 Free tarso-conjunctival grafts can also carry significant problems with reported complication rates of up to 25% 10,29 including pyogenic granuloma, wound dehiscence, and chronic chemosis. 10,27 Baylis et al 12 reported the use of auricular grafts in 83 eyelids and found a lower complication rate of 3.6%, including foreign-body sensation and poor eyelid contour.…”

“…17 We found a mean improvement of lower-eyelid height of 1.4 mm (range, 0.2 to 6.6) without the need for a spacer and the inherent risks. Oestreicher et al 29 reported surgery on 659 eyelids in 400 patients using posterior lamellar grafting and inferior retractor release. They found an overall complication rate of 17.5% with HPMG.…”

Durch eine kleine temporale Tarsorrhaphie lässt sich der Effekt der Unterlidverlängerung mit Implantat bei Patienten einer Endokrinen Orbitopathie signifikant steigern

“…Viele organische als auch anorganische Materialien wurden als Platzhalter erprobt: z. B. Ohrknorpel [5], harter Gaumen mit Mukosa [6], Polyethylene-Medpor-Mikroplatten [7], Tarsokonjunktivaltransplantate [8,9], sogenannte "porcine acellular dermal matrix" [10] und Spendersklera bzw. Spenderperikard [11,12].…”