Congenital Eyelid Retraction

Collin, J. R. O.; Allen, L. H.; Castronuovo, S.

doi:10.1097/00002341-199109000-00021

Cited by 3 publications

(4 citation statements)

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“…Seventy percent of patients (n ¼ 7/10) were euthyroid at the time of surgery and 70% had received steroid treatment for that condition. The average follow-up was 13 months (range [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The indication for eyelid lowering was lagophthalmos in five (42%) (mean degree of lagophthalmos was 1.9 mm (range 1-6.5 mm)), foreign body sensation in eight (67%), photophobia in seven (58%), and symptomatic epiphora in three (25%).…”

Section: Resultsmentioning

confidence: 99%

“…1,2 These techniques are based on weakening or lengthening the upper-eyelid retractors and include anterior or posterior approaches to graded recession or resection of Mü ller's muscle, [3][4][5] levator aponeurosis (LA)/muscle, [6][7][8] or both, 5,[9][10][11][12][13][14] full-thickness blepharotomy, [15][16][17] levator lengthening by marginal myotomy, 18,19 z-myotomy, 20 castellated levator aponeurotomy, 21 reattachment of the recessed levator to the tarsus by various spacers (sclera, 22,23 mersilene mesh, 24,25 sutures, 26,27 adjustable sutures, 28,29 orbital septal flap, 30 pretarsal soft tissues, 31 and deep temporal fascia 32 ), pedicle tarsal rotation flap, 33 or medial transposition of the lateral horn of the LA. 34 The orbital septum (OS) arises from the arcus marginalis and terminates inferiorly as it attaches to the LA; it can be used as a vascularized turn-over flap to act as a spacer between the recessed LA-Muller's muscle complex-Muller's muscle complex and the tarsal plate.…”

Section: Introductionmentioning

confidence: 99%

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Turn-over orbital septal flap and levator recession for upper-eyelid retraction secondary to thyroid eye disease

Watanabe

Shams

Katori

et al. 2013

Eye

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Background A turn-over septal flap has been reported as a spacer for levator lengthening in a single case report. This study reports the preliminary outcomes of this technique in a series of patients with upper-lid retraction (ULR) associated with thyroid eye disease (TED) causing symptomatic exposure keratopathy (EK). Methods Retrospective, multicenter study of 12 eyelids of 10 patients with TED undergoing a transcutaneous levatorlengthening technique using the reflected orbital septum (OS) as a spacer. Change in palpebral aperture (PA) and contour, position of the skin crease (SC), symptoms of EK, and complications were recorded. Results The average age was 47.5 years. Two patients were excluded, as their septa were found to be very thin at surgery. At an average of 13 months postoperatively, the PA was reduced by 2.5 mm on average (Po0.001) and was within 1 mm of the contralateral eyelid in 11 cases (92%); the position of the SC was within 1 mm of the desired position in all cases. EK resolved in all cases. Complications included one case of overcorrection and one case of recurrent lateral flare. Conclusions The turn-over orbital septal flap technique may be a viable option as an autogenous spacer for the treatment of ULR in TED. This technique may be possible in cases where the OS has been opened by previous surgery but may not be feasible in patients in whom the septum is very thin.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Turn-over orbital septal flap and levator recession for upper-eyelid retraction secondary to thyroid eye disease

Watanabe

Shams

Katori

et al. 2013

Eye

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“…In addition to nonsurgical treatments, multiple techniques have been reported to achieve favorable outcomes. These include recession/resection of Muller's muscle alone 2 ; recession/resection of the levator muscle and aponeurosis recession/resection with or without Muller's muscle [12][13][14] ; levator lengthening by marginal myotomy/Z myotomy 11,15,16 ; or reattachment of the recessed levator to the tarsus with various flaps or spacers, [17][18][19] adjustable sutures, 20 or using an anterior or posterior approach. However, none of these has been proven superior.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Orbital Septal Flap in the Treatment of Moderate and Severe Upper Eyelid Retraction

Nguyen²,

Bui³

et al. 2021

Ophthalmic Plastic &Amp; Reconstructive Surgery

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To assess the long-term effectiveness of the orbital septal flap to lengthen the levator muscle in management of moderate and severe upper eyelid retraction.Methods: This study reports 46 eyes of 43 consecutive patients with moderate or severe upper eyelid retraction who were recommended for surgery. The period of the study was between October 2016 and October 2019. All cases were evaluated for eyelid position before and at 3, 6, and 12 months after the operation. Successful outcome was defined as "perfect," "acceptable," and "failure".Results: The average age was 33.3 years (range, 16-59 years). The average orbital septal flap height was 5.28 ± 0.77 mm. Before surgery, 78.3% had 1 of 3 central upper eyelid retraction (group 1), and 21.7% had 1 of 3 lateral upper eyelid retraction (group 2). During follow-up postoperatively, all eyelid parameters of upper marginal reflex distance, upper scleral show, and palpebral fissure height significantly decreased compared with preoperative values in both groups. The result was considered "perfect" or "acceptable" in 42 eyes (91.3%). However, at 12 months after surgery, of the 36 middle eyelid retraction cases (group 1), 35 (97.2%) showed a successful outcome (perfect or acceptable results), while the success rate in group 2 was 70% (7 of 10 cases), a significant difference (p = 0.008). No severe complications were seen during follow up.Conclusions: Orbital septal flap is a safe and reliable procedure for management of upper eyelid retraction of moderate and severe degree.

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“…Etiologies of pediatric lower eyelid retraction include thyroid eye disease, primary congenital eyelid laxity, congenital glaucoma, high myopia and other rare causes. [2][3][4][5][6] This study describes four pediatric patients (six eyes) with lower eyelid retraction who exhibited buphthalmos, including one eye with secondary glaucoma caused by Sturge-Weber syndrome.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of surgery for epiblepharon accompanied with lower eyelid retraction secondary to buphthalmos in children

Cao

Wang

et al. 2021

Pediatric Investigation

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Importance: In cases of epiblepharon with lower eyelid retraction secondary to glaucoma, correcting epiblepharon alone is ineffective. Combined surgery should be performed to obtain satisfactory outcomes. Objective: To investigate outcomes after surgery to correct epiblepharon with lower eyelid retraction secondary to buphthalmos in children. Methods: A retrospective analysis of six eyes in four patients was performed included lower lid retractor recession combined with marginal rotation with tarsal fixation. The margin reflex distance-2, lagophthalmus, resolution of clinical symptoms, and complications were assessed during 6 to 12 months of follow-up. Results: In all cases, epiblepharon and lagophthalmus were corrected, symptoms of photophobia and epiphora were relieved, and the corneal epithelium was repaired. The margin reflex distance-2 decreased and remained normal during the follow-up period, but slightly regressed within 6 months postoperatively. Interpretation: Epiblepharon caused by buphthalmos in children is often associated with lower eyelid retraction. Lower lid retractor recession combined with marginal rotation with tarsal fixation fundamentally solves the problems of high eyelid tension, lower eyelid retraction, and epiblepharon and reduces the recurrence rate.

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Congenital Eyelid Retraction

Cited by 3 publications

References 0 publications

Turn-over orbital septal flap and levator recession for upper-eyelid retraction secondary to thyroid eye disease

Turn-over orbital septal flap and levator recession for upper-eyelid retraction secondary to thyroid eye disease

The Efficacy of Orbital Septal Flap in the Treatment of Moderate and Severe Upper Eyelid Retraction

Outcomes of surgery for epiblepharon accompanied with lower eyelid retraction secondary to buphthalmos in children

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