Advertisement

Eyelid Retraction

  • John D. Ng
  • Laura A. Gadzala
Chapter

Abstract

Eyelid retraction can affect the upper and lower eyelids, as well as any or all of the three lamellae of the lid. Common sources of retraction include inflammation, including thyroid disease, trauma, and iatrogenic causes. Indications for surgical repair include lagophthalmos, exposure keratopathy, dryness, and cosmesis. Surgical repair must address any aspect of anterior or posterior lamellar shortage that may be present while not neglecting other factors at play, including lid laxity, negative eyelid vector, and muscle weakness. Multiple surgical techniques, including flaps, spacers, and grafts, as well as combinations of these, can be utilized to successfully address the multiple components contributing to eyelid retraction. Careful preoperative evaluation and surgical planning cannot be overemphasized in the pursuit of satisfactory outcomes for patient and surgeon.

Keywords

Eyelid retraction Exposure keratopathy Cicatricial Full-thickness skin graft 

Supplementary material

419986_5_En_25_MOESM1_ESM.mp4 (100.4 mb)
Video 25.1 Full-thickness skin graft from retroauricular area. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/1/Full-thickness-graft-retroauricular.htm (MP4 102763 kb)
419986_5_En_25_MOESM2_ESM.mp4 (61.2 mb)
Video 25.2 Harvesting of preauricular full-thickness skin graft. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/8/4-preauricular-skin-graft-harvest.htm (MP4 62632 kb)
419986_5_En_25_MOESM3_ESM.mp4 (93.9 mb)
Video 25.3 Full-thickness skin graft from supraclavicular area. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/1/Full-thickness-graft-supraclavicular.htm (MP4 96158 kb)
419986_5_En_25_MOESM4_ESM.mp4 (59.6 mb)
Video 25.4 Full-thickness skin graft harvested from the inside of the upper arm. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/1/Full-thickness-graft-inside-upper-arm.htm (MP4 61057 kb)
419986_5_En_25_MOESM5_ESM.mp4 (85.6 mb)
Video 25.5 Hard palate graft harvest. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/4/10-hard-palate-graft-harvest.htm (MP4 87651 kb)
419986_5_En_25_MOESM6_ESM.mp4 (127.7 mb)
Video 25.6 Harvesting of ear cartilage graft. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/4/1-harvesting-ear-cartilage.htm (MP4 130740 kb)
419986_5_En_25_MOESM7_ESM.mp4 (100.1 mb)
Video 25.7 Hard palate graft for lower eyelid retraction. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/2/hard-palate-graft.htm (MP4 102498 kb)
419986_5_En_25_MOESM8_ESM.mp4 (189.1 mb)
Video 25.8 Enduragen graft to lower eyelid. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/1/enduragen.htm (MP4 193622 kb)
419986_5_En_25_MOESM9_ESM.mp4 (303.3 mb)
Video 25.9 Lower lid elevation with ear cartilage graft. Courtesy of Richard C. Allen, MD, PhD, FACS. http://webeye.ophth.uiowa.edu/eyeforum/video/plastics/4/2-ear-cartilage-ll-retraction.htm (MP4 310533 kb)

References

  1. 1.
    Bee YS, Alonzo B, Ng JD. Review of AlloDerm acellular human dermis regenerative tissue matrix in multiple types of oculofacial plastic and reconstructive surgery. Ophthalmic Plast Reconstr Surg. 2015;31(5):348–51.CrossRefPubMedGoogle Scholar
  2. 2.
    Brown BZ, Beard C. Split-level full-thickness eyelid graft. Am J Ophthalmol. 1979;87(3):388–92.CrossRefPubMedGoogle Scholar
  3. 3.
    Scruggs JT, McGwin G Jr, Morgenstern KE. Use of noncadaveric human acellular dermal tissue (BellaDerm) in lower eyelid retraction repair. Ophthalmic Plast Reconstr Surg. 2015;31(5):379–84.CrossRefPubMedGoogle Scholar
  4. 4.
    Dailey RA, Marx DP, Ahn ES. Porcine dermal collagen in lower eyelid retraction repair. Ophthalmic Plast Reconstr Surg. 2015;31(3):233–41.CrossRefPubMedGoogle Scholar
  5. 5.
    Smith RJ, Malet T. Auricular cartilage grafting to correct lower conjunctival fornix retraction and eyelid malposition in anophthalmic patients. Ophthalmic Plast Reconstr Surg. 2008;24(1):13–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Oculofacial Plastics, Orbital and Reconstructive Surgery, Departments of Ophthalmology and Otolaryngology/Head & Neck SurgeryOregon Health and Science University, Casey Eye InstitutePortlandUSA
  2. 2.Oculofacial Plastics, Orbital and Reconstructive Surgery ServiceLegacy Devers Eye InstitutePortlandUSA

Personalised recommendations