Surgical Treatment of Proptosis due to High-axial Myopia During Lower Eyelid Blepharoplasty in Identical Twins

Eyelid injuries commonly occur as a result of blunt or sharp periocular trauma. When the medial canthal region is affected, injury can be associated with canalicular laceration or avulsion. Complete loss of the lacrimal canaliculus associated with epiphora is a challenging condition, and reconstruction often leads to poor and disappointing results. Surgical treatment of a patient following blunt facial trauma that resulted in medial avulsion of the lower eyelid with tissue loss is presented. A 72-year-old male patient presented with avulsion of the medial 2/3 of the left lower eyelid together with complete loss of the inferior canaliculus. Eyelid tissue was not preserved. The inferior canaliculus was reconstructed using a Mini Monoka (FCI Ophthalmics), which was sutured under the caruncle and was enveloped with surrounding tissue. Loss of the lower eyelid tissue was substituted with a medially shifted Hughes flap and free skin transplant from the ipsilateral upper eyelid. The Hughes flap was divided after 2 weeks, while the Mini Monoka extruded spontaneously approximately 3 months after the injury. Ten months after the injury, the opening of the reconstructed lower canaliculus was positioned under the caruncle and was patent on probing and syringing. The patient is without epiphora and is satisfied with the functional and aesthetic result. In eyelid injuries we follow certain rules of reconstruction, but each case is unique and requires some inventiveness. The idea of inferior canalicular reconstruction following lower-eyelid avulsion with tissue loss is presented.

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Surgical Treatment of Thyroid-Related Lower Eyelid Retraction

Ophthalmic Plastic and Reconstructive Surgery ◽

10.1097/00002341-199212000-00007 ◽

1992 ◽

Vol 8 (4) ◽

pp. 278-286 ◽

Cited By ~ 21

Author(s):

Kenneth A. Feldman ◽

Allen M. Putterman ◽

Marilyn D. Farber

Keyword(s):

Surgical Treatment ◽

Lower Eyelid ◽

Eyelid Retraction

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Surgical Treatment as a First Option of the Lower Eyelid Xanthelasma

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000003830 ◽

2017 ◽

Vol 28 (7) ◽

pp. e678-e679 ◽

Cited By ~ 2

Author(s):

Bojan Obradovic

Keyword(s):

Surgical Treatment ◽

Lower Eyelid

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Estimation algorithm of the lower eyelid tone

Ophthalmology journal ◽

10.17816/ov9310-14 ◽

2016 ◽

Vol 9 (3) ◽

pp. 10-14

Author(s):

Vitaly V. Potemkin ◽

Elena V. Ageeva

Keyword(s):

Surgical Treatment ◽

Estimation Algorithm ◽

Lower Eyelid ◽

Frequent Type ◽

Eyelid Malposition

The condition of ocular adnexal tissues plays an important role not only in determining the pathogenesis of eyelid malposition, but also in the choice of surgical treatment. The most frequent type of eyelid malpositions — involutional lower lid malpositions. Estimation algorithm of the lower eyelid tone was described in this article.

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Blepharoplasty in Extensive Lower Eyelid Eversion of Severe III–IV Degree

Ophthalmology in Russia ◽

10.18008/1816-5095-2021-3-433-441 ◽

2021 ◽

Vol 18 (3) ◽

pp. 433-441

Author(s):

I. V. Ivolgina

Keyword(s):

Surgical Treatment ◽

Lower Eyelid ◽

Group Iv ◽

Eyelid Margin ◽

Unsatisfactory Result ◽

Group Iii ◽

The Difference ◽

Efficacy Criteria ◽

Reconstructive Plastic Surgery ◽

Cicatricial Ectropion

Purpose. To analyze the efficacy of the lower eyelid eversions surgical treatment.Patients and Methods. We have analyzed the outcomes of treating patients with severe lower eyelid eversion during 2013–2019 — 153 patients, 156 operations. The patients were divided into 4 groups: atonic and paralytic eversion (109 eyes), traumatic tearing of the lower eyelid (8 eyes), cicatricial ectropion (28 eyes) and mechanical ectropion (in tumors) of the lower eyelid (11 eyes). The following surgeries were performed: duplicature surgery by Willer; by Kuhnt-Szymanowski; resection of the framework structure of the lower eyelid with fixation to the eyelid ligaments; implantation of various materials based on the orbital margin; sling to the eyelid ligaments; free skin plasty; local flaps; excision of tumors with one-stage reconstructive plastics.Results. Postoperatively the improvement was observed in all cases. The lower eyelid eversion was eliminated. There were no any complications. The efficacy criteria was the level of the eyelid margin height with regards to limbus, absence or reduction of lagophthalmus. “Good” result — symmetrical width of the eyelid fissure, absence of lagophthalmus was achieved in 100 % of cases in groups IA and II, in 28.12 % — in group IB, in 71.43 % — in group III, in 63.63 % — in group IV. “Satisfactory” result — the difference in the eyelid fissure width was 1.0–2.0 mm, absence or reduction of lagophthalmus was achieved in 65.62 % of cases in group IB, in 21.43 % — in group III, in 27.28 % — in group IV. “Unsatisfactory” result — the difference in the eyelid fissure width was more than 2.0 mm, the presence of lagophthalmus was achieved in 6.25 % of cases in group IB, in 7.14 % — in group III, in 3.33 % — in group IV.Conclusions. When operating the lower eyelid eversion it is possible to achieve good result. The pathogenically based combined methods of surgical treatment are the most effective. In case of traumatic tearing of the lower eyelid, we need to restore the lacrimal duct. In cicatricial ectropion it is possible to achieve engraftment of the skin graft, elimination of eversion and lagophthalmus. In mechanical eversion (due to eyelid tumors) it is necessary to perform radioexcision of the neoplasm with a single-stage reconstructive plastic surgery of the eyelid.

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