Eyelid Surgery in Gravesʼ Orbitopathy

2021 ◽  
Vol 238 (01) ◽  
pp. 33-40
Author(s):  
Christoph Hintschich
Keyword(s):  
Standard Procedure ◽  
Lower Eyelid ◽  
Volume Effect ◽  
Eyelid Retraction ◽  
Fat Tissue ◽  
Fat Pad ◽  
Upper Eyelid ◽  
Eyelid Surgery ◽  
Primary Procedure ◽  
Skin Excision

AbstractPatients with Gravesʼ orbitopathy often develop eyelid changes. These may be the result of a volume effect or a malposition. Both dermatochalasis with fat tissue increase and eyelid retraction may lead to functional or aesthetic impairment. The present article reviews indications, timing and principles for corrective eyelid surgery. If at all possible, surgical eyelid correction in Gravesʼ orbitopathy should be performed once the disease became inactive and stabile. Surgical details of eyelid lengthening procedures for upper and lower eyelid retraction are presented. Meanwhile anterior blepharotomy became the primary procedure for upper eyelid lengthening. However, there is no such standard procedure for lower eyelid lengthening, although it is recommended to use a spacer. For blepharoplasty it is mandatory to distinguish between orbital fat prolapse and subbrow fat pad. A prolapse of the lacrimal gland should not be missed and generally, skin excision performed sparingly.

scholarly journals Correction of Anophthalmic Enophthalmos with a Three-Staged Procedure: Two Case Reports

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Tomohiro Minagawa ◽  
Ryuta Shioya ◽  
Takeshi Yamao ◽  
Chigusa Sato ◽  
Taku Maeda
Keyword(s):  
Case Reports ◽  
Lower Eyelid ◽  
Surgical Correction ◽  
Cartilage Graft ◽  
Eyelid Retraction ◽  
Upper Eyelid ◽  
Sling Procedure ◽  
Upper Eyelid Ptosis ◽  
Prosthetic Eye

Surgical correction of an anophthalmic enophthalmos secondary to inappropriate repair of the eye socket involves several difficult aesthetic issues associated with long-term use of a poorly fitting prosthetic eye. In this paper, we present two cases of anophthalmic enophthalmos. During the treatment of the first patient, unsatisfactory cosmetic problems including lower eyelid retraction, hypoglobus, and severe upper eyelid ptosis were revealed. Accordingly, a three-staged procedure was performed on the second patient, including autologous augmentation of the eye socket, correction of lower eyelid retraction with a cartilage graft, and a frontalis sling procedure to correct upper eyelid ptosis.

scholarly journals The Effect of Levator Recession for Upper Eyelid Retraction in Patients with Thyroid-associated Ophthalmopathy

2021 ◽  
Vol 62 (8) ◽  
pp. 1015-1021
Author(s):  
Ja Young Oh ◽  
Jeong Kyu Lee
Keyword(s):  
Medical Records ◽  
Multivariate Logistic Regression Analysis ◽  
Lower Eyelid ◽  
Eyelid Retraction ◽  
Upper Eyelid ◽  
Factors Affecting ◽  
Thyroid Associated Ophthalmopathy ◽  
Before And After ◽  
Upper Eyelid Retraction ◽  
The Difference

Purpose: We analyzed factors that affect the outcome of levator recession surgery for upper eyelid retraction in patients with thyroid-associated ophthalmopathy.Methods: Retrospective analysis was performed based on the medical records of 24 patients with thyroid-associated ophthalmopathy who underwent upper eyelid levator recession surgery between February 10, 2010, and September 18, 2018. The margin to reflex distance (MRD), length and area of the upper and lower eyelids were measured and compared with the eyelid analysis software before and after 6 months of surgery on medical records. In addition, factors affecting the difference in MRD1 before and after surgery were examined by multivariate linear regression analysis.Results: Twenty-four patients were included in the study. The MRD1 decreased significantly from 5.12 ± 1.26 mm before surgery to 3.48 ± 1.08 mm at 6 months after surgery (p < 0.001). All upper eyelid measurements, i.e., UEL (p < 0.001), UMA (p < 0.001), UCA (p = 0.004), and ULA (p < 0.001), were significantly decreased after surgery, while none of the lower eyelid measurements showed significant changes. Multivariate logistic regression analysis indicated that lower preoperative MRD1 was associated with the success of the surgery (odds ratio, 0.31; 95% confidence interval, 0.09-1.01).Conclusions: Levator recession surgery is an efficient surgical method that can correct the upper eyelid retraction associated with thyroid-associated ophthalmopathy.

Management of Cosmetic Eyelid Surgery Complications

2003 ◽  
Vol 20 (2) ◽  
pp. 83-88 ◽  
Author(s):  
William P. Mack ◽  
Mont J. Cartwright ◽  
John P. Fezza ◽  
Patrick M. Flaharty
Keyword(s):  
Dry Eye ◽  
Preoperative Evaluation ◽  
Lower Eyelid ◽  
Dry Eye Syndrome ◽  
Surgery Complications ◽  
Medication History ◽  
Upper Eyelid ◽  
Eyelid Surgery ◽  
Intraoperative Management ◽  
Orbital Hemorrhage

Purpose: Preoperative evaluation with detailed surgical planning is imperative to avoid potential complications in cosmetic eyelid surgery. Materials and Methods: Before undergoing cosmetic upper eyelid blepharoplasty, patients should be thoroughly evaluated. Patients should be examined for ptosis, dry eye syndrome, prolapsed lacrimal gland, and brow ptosis. In addition to the evaluation for dry eye syndrome, patients interested in cosmetic lower eyelid blepharoplasty should be assessed for ectropion, entropion, lid retraction, scleral show, lid laxity, and lagophthalmos. Preoperatively, risk factors for orbital hemorrhage, including hypertension, anti-platelet or anticoagulant medication, history of abnormal bruising of bleeding, or underlying diseases that may contribute to bleeding, should be assessed. Intraoperative management of cosmetic upper eyelid surgery complications should focus on decreasing the risk of postoperative ptosis, lagophthalmos, lid retraction, and lid asymmetry, with special attention to limiting the risk of visual loss secondary to orbital hemorrhage. Discussion: Management of cosmetic lower eyelid blepharoplasty complications should focus on methods to assess lower lid laxity, limit the risk of diplopia, and manage orbital hemorrhage. Results: Techniques to revise cosmetic eyelid surgery complications during the postoperative period will be described.

An Accurate Upper Lid Blepharoplasty: A Key Component of Facial Rejuvenation

2021 ◽  
Author(s):  
Zachary Zimmerman ◽  
James Regan Thomas
Keyword(s):  
Operative Time ◽  
Skin Incision ◽  
Accurate Assessment ◽  
Upper Eyelid ◽  
Common Procedure ◽  
Eyelid Surgery ◽  
Excess Skin ◽  
Facial Plastic ◽  
Skin Excision ◽  
Upper Lid

AbstractUpper eyelid surgery is a common procedure performed by a variety of subspecialists including facial plastic surgeons, oculoplastic surgeons, general otolaryngologists, and plastic surgeons. Traditionally, a skin incision is marked in the preoperative setting to allow for an excision that eliminates upper eyelid hooding while preventing lagophthalmos. Many different methodologies have been proposed to maximize results and minimize complications. In this article, the authors propose a unique way to safely and effectively address dermatochalasis. The pinch technique allows for an accurate assessment of excess skin and provides a method that requires less operative time than traditional techniques. The use of both local anesthetic with epinephrine and hyaluronidase helps achieve the appropriate plane and attain better hemostasis. Importantly, the presented technique allows for reassessment and revision of the amount of skin excision before incision creation. It is a useful methodology for any surgeon performing upper lid blepharoplasty.

scholarly journals Blepharoplasty in Graves’ Ophthalmopathy

2017 ◽  
Vol 1 (1) ◽  
pp. s-0037-1607031
Author(s):  
Gabriele Bocchialini ◽  
Andrea Castellani ◽  
Umberto Zanetti
Keyword(s):  
Lower Eyelid ◽  
Graves Disease ◽  
Orbital Decompression ◽  
Eyelid Retraction ◽  
Surgical Time ◽  
Eyelid Surgery ◽  
Graves Ophthalmopathy

Graves’ ophthalmopathy (GO) is the main extrathyroidal manifestation of Graves’ disease. Many patients require rehabilitative surgery, such as orbital decompression and lipectomy, to restore function and appearance. Graves’ lower eyelid retraction is a common, controversial sign and is resolved in most cases by eyelid surgery, which is very effective and incredibly simple compared with other kinds of surgeries in terms of comorbidity, surgical time, complications, and esthetic results. Here, we describe blepharoplasty in a patient with Graves’ ophthalmopathy.

Management of Eyelid Retraction

2011 ◽  
Author(s):  
Alexander Taich ◽  
Adam S. Hassan
Keyword(s):  
Rectus Muscle ◽  
Lower Eyelid ◽  
Eyelid Retraction ◽  
Adrenergic Stimulation ◽  
Inferior Rectus ◽  
Blurred Vision ◽  
Eyelid Margin ◽  
Upper Eyelid ◽  
Inferior Rectus Muscle ◽  
Stimulation Of

Eyelid retraction has numerous causes. Most notably eyelid retraction is caused by thyroid eye disease (TED), trauma, and postsurgical changes. The upper eyelid margin is typically measured at 3.5 to 4.5 mm above the center of the cornea. The lower eyelid margin is typically situated at the inferior border of the limbus. Eyelid retraction is a condition in which the upper eyelid margin is displaced superiorly or the lower eyelid margin is displaced inferiorly. Eyelid retraction may result in exposure keratopathy and disturbing ocular symptoms, including blurred vision, photophobia, foreign body sensation, burning, and reactive tearing. Eyelid retraction in TED is thought to be due to a combination of inflammation, fibrosis, and adrenergic stimulation of the eyelid retractors. Proptosis can also contribute to eyelid retraction. In the upper eyelid, factors responsible for eyelid retraction include (1) inflammation and fibrosis of the levator and Müller’s muscles, (2) adrenergic stimulation of Müller’s muscle, and (3) inflammation and fibrosis of the inferior rectus muscle, causing hypodeviation of the globe and compensatory overaction of the superior rectus–levator complex. In the lower eyelid, factors responsible for eyelid retraction include (1) inflammation and fibrosis of the inferior rectus muscle with consequent traction on its anterior extension, the capsulopalpebral fascia, which is the main lower lid retractor, and (2) adrenergic stimulation of the smooth muscle fibers within the lower lid retractor complex. A combination of eyelid retraction and proptosis in TED may result in ocular exposure with symptoms of ocular irritation, an undesirable cosmetic appearance, corneal erosion and infection, or (rarely) globe luxation. Mild exposure problems can be managed with topical lubricants. Guanethidine, a topical sympatholytic agent, is of limited usefulness in the management of eyelid retraction due to its variable efficacy and frequent ocular side effects, including irritation, hyperemia, photophobia, pain, edema, burning sensation, and punctate keratitis. It may be more tolerable if used in lower concentrations. Exposure problems in the inflammatory phase of the condition present a special challenge as surgical correction of eyelid retraction is best performed in the pos-tinflammatory, stable phase. Several reports have described using Botulinum toxin injections, 2.5 to 15 U, either subconjunctivally or percutaneously, just above the superior border of the tarsus.

RESULTS OF INTRALESIONAL TRIAMCINOLONE ACETONIDE FOR CHALAZION TREATMENT

2011 ◽  
pp. 100-104
Author(s):  
Thi Thu Nguyen ◽  
Viet Hien Vo ◽  
Thi Em Do
Keyword(s):  
Success Rate ◽  
Key Words ◽  
Triamcinolone Acetonide ◽  
Lower Eyelid ◽  
Upper Eyelid ◽  
Interventional Trial ◽  
The Mean ◽  
First Time

The study use intralesional triamcinolone acetonide injection proceduce for chalazion treatment.1. Objectives: To evaluate results of intralesional triamcinolone acetonide injection for chalazion treatment. 2. Method: This noncomparative prospective interventional trial included 72 chalazions of 61 patients. 3. Results: 61 patients (72 chalazions) with 19 males (31.1%) và 42 females (68.9%), the mean age was 24 ± 9,78 years. 31.1% patients was the first time chalazion and 68.9% patients was more than one times chalazion including 78.6% patients was recurrent at the first position and 21.4% patients occur at new position. 72 chalazions with 16 (22.2%) chalazions was treated before and 56 (77.8%) chalazions wasn’t done that. 72 chalazions with 49 chalazions (68.1%) are local in upper eyelid and 23 chalazions (31.9%) are local in lower eyelid. The mean of chalazion diameter is 6.99 ± 3.03mm. Intralesional triamcinolone acetonide is injected to treat 72 chalazions with 16 (22.2%) chalazions are injected through the route of skin and 56 (77.8%) chalazions are injected through the route of conjunctiva. After 2 weeks follow-up, the success rate was 93.1% and 6.9% failed. 4. Conclusion: intralesional triamcinolone acetonide injection for chalazion treatment is really effective. Key words: chalazion, intralesional triamcinolone acetonide.

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

2021 ◽  
Author(s):  
Wenhong Cao ◽  
Yuan Wang ◽  
Li Li ◽  
Yunwei Fan ◽  
Wen Liu ◽  
...  
Keyword(s):  
Lower Eyelid ◽  
Eyelid Retraction
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