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Subperiosteal midface lift with or without a hard palate mucosal graft for correction of lower eyelid retraction.

Abstract：

PURPOSE:To compare functional and surgical outcomes of a subperiosteal midface lift with and without the placement of a hard palate mucosal graft (HPMG) in patients with lower eyelid retraction. DESIGN:Retrospective, comparative, interventional case series. PARTICIPANTS:Thirty-four patients with lower eyelid retractions who underwent surgery at the Jules Stein Eye Institute in a 5-year period. METHODS:Medical record review of all patients who underwent surgery for lower eyelid retraction by a subperiosteal midface lift with or without an HPMG. Preoperative and postoperative digital photographs were taken in all patients. MAIN OUTCOME MEASURES:Change in margin reflex distance 2 (MRD2), measured from the pupillary margin to the upper margin of the lower eyelid; patient discomfort; and surgical complications. RESULTS:Thirty-four patients (20 female; mean age, 64 years) participated in the study; 11 underwent bilateral surgery, with overall 43 surgeries performed. Eighteen patients (42%) had lower eyelid retraction secondary to previous transcutaneous lower eyelid blepharoplasty. Postoperatively, patients attained a better lower eyelid position, with improvement of lower eyelid height of 1.4 mm (P<0.001, 1-sample t test). Patients operated using an HPMG (12 surgeries) achieved a greater reduction in MRD2 postoperatively as compared with patients operated by subperiosteal midface lift alone (31 surgeries; 2.2 mm vs. 1.1 mm, respectively; P = 0.02, Wilcoxon Mann-Whitney). One patient needed reoperation secondary to symptomatic lower eyelid retraction postoperatively. CONCLUSIONS:The subperiosteal midface lift is effective in correction of lower eyelid retraction of various causes. The use of an HPMG spacer may enhance surgical outcomes and results in a better lower eyelid position.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

Ben Simon GJ,Lee S,Schwarcz RM,McCann JD,Goldberg RA

doi

10.1016/j.ophtha.2006.05.014

subject

Has Abstract

pub_date

2006-10-01 00:00:00

pages

1869-73

issue

10

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(06)00674-9

journal_volume

113

pub_type

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