The Management of Ectropion Using the Tarsoconjunctival Composite Graft

Implants and spacers for paralytic ectropion: Literature review and assessment of a thin-profile porous polyethylene implant

“…Tarsal grafting from the contralateral upper eyelid was performed by Shaw in nine patients with paralytic ectropion. [ 26 ] Combined with canthoplasty, the graft was sutured to the tarsal border through a subciliary incision with good results. Tarsus is the ideal graft because of its conjunctival surface, yet an obvious limitation is the finite amount of upper eyelid tarsus available at the donor site and the desire to preserve normal eyelid architecture.…”

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

“…1,2,4 -6,8,9,11-13,16,21,22,25 A second group states that their patients improved with regard to scleral show, lagophthalmos, subjective symptoms, and signs such as SPK, but no actual measurements are given. 3,17,18,20,23 The last group includes objective measurements in their study; 7,10,14,15,19,24 these are discussed here. Holds et al 7 describe at least 1 mm of scleral show improvement in 200 eyelids, with an in-glove retractor lysis technique.…”

Correction of lower eyelid retraction in thyroid eye disease: a randomised controlled trial of retractor tenotomy with adjuvant antimetabolite versus scleral graft

“…Buccal mucosa grafts25 may be more easily harvested under local anaesthesia but do not provide structural support per se in the lower lid. Other autogenous grafts include auricular cartilage,14 which may be harvested in small amounts from the concha under local anaesthesia, and free tarsoconjunctival grafts21 24 which are also easily harvested, but healing of the donor site may theoretically exacerbate upper eyelid retraction.…”

“…Surgery to correct lower eyelid retraction may include either a graft or a non-graft technique 1-24. Grafts may be autogenous—for example, as hard palate mucosa,13 15 20 auricular cartilage,14 tarsal conjunctiva,21 24 and buccal mucosa,25 or may be from an exogenous donor such as sclera. Donor sclera has a risk of transmission of HIV or slow viruses, may be of limited availability and may not be acceptable to the patient for ethical reasons.…”