title: Lower eyelid reverse ptosis repair.
abstract: OBJECTIVE
  To report the results of the surgical repair of lower eyelid reverse ptosis.
  
  
  METHODS
  Retrospective case series. Eight patients ranging in age from 31 to 77 years underwent surgical repair of lower eyelid reverse ptosis. The pupillary axis of the affected eye(s) in each patient was obscured in downgaze, interfering with reading. The lower eyelid reverse ptosis resulted from involutional changes in 3 patients, previous orbital decompression in 3 patients, multiple prior retinal and extraocular muscle operations in 1 patient, and previous orbital floor fracture and repair in 1 patient. Transcutaneous advancement of the lower eyelid retractors was performed in 12 eyelids of the 8 patients.
  
  
  RESULTS
  The mean preoperative vertical eyelid fissure was 6.2 mm (median, 6 mm; range, 3-9 mm), increasing after surgery to a mean of 7.7 mm (median, 8 mm; range, 5-11 mm). The mean preoperative distance between the central light reflex and the lower eyelid margin was 1.7 mm (median, 1.25 mm; range, 1-4 mm); this distance increased to a mean of 3.3 mm (median, 3.25 mm; range, 2.5-4.5 mm) after surgery. Symptoms improved in all patients, and there were no perioperative complications. Follow-up intervals ranged from 2 months to 24 months (mean, 9 months; median, 13 months).
  
  
  CONCLUSIONS
  Analogous to upper eyelid ptosis repair by advancement of the levator aponeurosis, lower eyelid reverse ptosis may be corrected effectively and safely by advancing the lower eyelid retractors.
authors.affiliation: Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: George B
authors.initials: GB
authors.lastname: Bartley
authors.forename: Bartley R
authors.initials: BR
authors.lastname: Frueh
authors.forename: John B
authors.initials: JB
authors.lastname: Holds
authors.forename: John V
authors.initials: JV
authors.lastname: Linberg
authors.forename: Bhupendra C K
authors.initials: BC
authors.lastname: Patel
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Hawes
mesh_terms: D000328:Adult; D000368:Aged; D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D012189:Retrospective Studies