From the Department of Plastic Surgery, University of Texas Southwestern Medical School.
Baylor University.
Plast Reconstr Surg. 2023 Jul 1;152(1):66e-71e. doi: 10.1097/PRS.0000000000010206. Epub 2023 Jun 29.
Lower eyelid retraction is a common and feared complication of both disease processes and aesthetic and cosmetic surgical procedures. A four-finger approach has been previously described to determine adequate treatment of lid retraction. In the authors' experience, they have found that even the most aggressive treatment approach-subperiosteal cheek lift with canthopexy and interpositional graft-is inadequate to address severe lower lid retraction.
The authors propose a technique of a lower lid fascial sling with a lateral burr hole for support to be used when all five fingers are needed to correct the lower lid retraction. Review of 134 patients who underwent the fascia lata sling with lateral burr hole for severe lower lid retraction was performed.
The fascia lata sling with lateral burr hole adequately corrected the lid retraction in all but one patient in one procedure. This patient had persistent lateral ectropion and underwent revision canthoplasty, resulting in resolution of the lateral ectropion.
The fascia lata sling with lateral burr hole is a reliable procedure to correct lid retraction from a wide variety of causes.
下眼睑退缩是疾病过程和美容及整容手术的常见且令人恐惧的并发症。先前已经描述了四指方法来确定眼睑退缩的充分治疗。作者发现，即使是最激进的治疗方法——骨膜下颊提升术联合结膜囊固定术和间置移植物术——也不足以解决严重的下眼睑退缩。
当需要用五指来纠正下眼睑退缩时，作者提出了一种下眼睑筋膜吊带加外侧骨孔支撑的技术。对 134 例因严重下眼睑退缩而行阔筋膜悬吊加外侧骨孔的患者进行了回顾性研究。
除 1 例患者外，阔筋膜悬吊加外侧骨孔在一次手术中均能充分纠正眼睑退缩。该患者仍有外侧眼睑外翻，行二期矫正术，外侧眼睑外翻得到缓解。
阔筋膜悬吊加外侧骨孔是一种可靠的方法，可纠正各种原因引起的眼睑退缩。
