Effectiveness of the Lower Eyelid Suspension Using Fascia Lata Graft for the Treatment of Lagophthalmos due to Facial Paralysis

Abstract

Purpose. To evaluate of functional and cosmetic effectiveness of lower eyelid sling technique with fascia lata graft in patients with lagophthalmos due to facial paralysis. Material and Method. Ten patients with a mean age of 55.1 ± 19.77 years who underwent lower eyelid sling surgery with a fascia lata graft between September 2011 and January 2014 were included in this prospective study. Preoperatively and postoperatively patients were evaluated in terms of corneal epithelial defects, Schirmer's test, and tear break-up time (TBUT). Cosmetically, vertical eyelid aperture, margin reflex distances 1 and 2 (MRD1 and MRD2) and scleral show were evaluated preoperatively and postoperatively. Results. One patient had facial paralysis on the right side whereas the other 9 patients had facial paralysis on the left side. Preoperatively, 3 patients were detected with corneal ulcer, whereas 7 patients were detected with persistent corneal epithelial defects localized in the lower half of the cornea. In the 3 patients with preoperative corneal ulcer, the ulcer recovered with corneal opacity, whereas in the 7 patients with punctate epitheliopathy, postoperative corneal transparency was obtained. Discussion. Lower eyelid sling technique with fascia lata graft is an effective technique for the repositioning of the lower eyelid and preventing the corneal complications.

The Use of Fascia Lata Free Graft for Lateral Canthus Reconstruction Following Mohs Lower Lid Surgery

“…Fascia slings are also used to correct the lower eyelid position [11,12]. In the past, few authors have described the use of fascia lata in reconstruction of the lateral canthal ligament [13][14][15]. Sendul et al presented this approach in the treatment of lagophthalmos due to facial paralysis.…”

“…Sendul et al presented this approach in the treatment of lagophthalmos due to facial paralysis. They repositioned the lower eyelid with an autologous fascia lata graft attaching it to the orbital rim [15]. Matsumoto et al used fascia lata to support a cheek flap in lower eyelid reconstruction [14].…”

Pediatric facial reanimation: An algorithmic approach and systematic review

“…In addition, contralateral lower lip depressor labii inferioris resection has proven helpful for achieving symmetry in patients with long-standing marginal mandibular nerve palsy [19]. In patients with total orbicularis oculi paralysis, tensor fascia lata slings to the lower eyelid can also provide effective corneal protection [20]. Long-term, however, these static options and adjuncts require multiple revisions as children grow and underscore the importance of robust dynamic reconstructions.…”

Outcomes of lower eyelid retractor recession and lateral horn lysis in lower eyelid elevation for facial nerve palsy

“…Many procedures have been described to address lower-eyelid retraction. These include tarsorrhaphy, 1 canthal suspension, 2,3 periocular placement of fascia lata slings 4 and mid-facial sub-orbicularis oculi muscle/fat pad elevation. [5][6][7] Lower eyelid retractor recession (RR) has also been previously described as a procedure for correction of lower eyelid retraction.…”