Rana Harkaran S, Liddell Aaron T, Patadia Amol H, Dertinger Jake E, Fante Robert G, Willoughby Brian J
Department of Surgery, Trauma and Emergency Subspecialty Surgeons, Denver, Colorado, USA.
Swedish Medical Center, Englewood, Colorado, USA.
Orbit. 2025 Aug;44(4):420-425. doi: 10.1080/01676830.2024.2412789. Epub 2024 Oct 15.
The aim of this retrospective case review is to present a novel surgical technique used in the treatment of recalcitrant lower eyelid retraction.
This study was performed as a retrospective case review of 4 patients who have failed standard conservative surgical interventions for lower eyelid retraction repair. 3 patients developed lower eyelid retraction following surgical intervention for orbital trauma and 1 patient developed lower eyelid retraction in the setting of granulomatosis with polyangiitis. The surgical technique was identical in each patient and performed by an oculofacial plastic surgeon, sometimes together with an oral and maxillofacial surgeon. Follow-up results for all patients were assessed at 1 week, 1 month, and 3 months.
All four patients demonstrated initial improvement in lower eyelid position, fullness, and height. A common finding was mild lateral postoperative entropion, which was easily overcome with an upper eyelid tarsoconjunctival flap. There were no surgical complications sustained in any of the cases.
This retrospective case review provides a novel surgical option for the correction of recalcitrant lower eyelid retraction. The excellent vascularity provided by this flap, location, and easy access support its use. A prospective study comparing alternative solutions would be useful in comparing the buccal fat pad vascularized pedicle to alternative methods used to correct refractory and cicatricial lower eyelid retraction.
本回顾性病例分析的目的是介绍一种用于治疗顽固性下睑退缩的新型手术技术。
本研究是对4例下睑退缩修复标准保守手术干预失败的患者进行的回顾性病例分析。3例患者在眼眶外伤手术干预后出现下睑退缩，1例患者在肉芽肿性多血管炎背景下出现下睑退缩。每位患者的手术技术相同，由眼面部整形外科医生进行，有时会同口腔颌面外科医生一起操作。在1周、1个月和3个月时评估所有患者的随访结果。
所有4例患者的下睑位置、饱满度和高度均有初步改善。一个常见的发现是术后轻度外侧睑内翻，通过上睑睑板结膜瓣很容易克服。所有病例均未出现手术并发症。
本回顾性病例分析为顽固性下睑退缩的矫正提供了一种新型手术选择。该皮瓣提供的良好血供、位置以及易于操作支持了其应用。一项比较替代方案的前瞻性研究将有助于比较带血管蒂的颊脂垫与用于矫正难治性和瘢痕性下睑退缩的替代方法。
