Graded full-thickness anterior blepharotomy for correction of upper eyelid retraction not associated with thyroid eye disease.
OBJECTIVE
To evaluate the efficacy of graded full-thickness anterior blepharotomy for upper eyelid retraction of various causes not associated with Graves eye disease.


METHODS
Twenty-one eyelids of 18 patients with upper eyelid retraction not caused by Graves eye disease were treated with graded full-thickness anterior blepharotomy. Preoperative and postoperative symptoms, midpupil to upper eyelid distance, lagophthalmos, and superficial punctuate keratopathy were evaluated.


RESULTS
Upper eyelid retraction was due to facial nerve palsy in 4 patients (22%), overcorrected ptosis in 5 patients (28%), and cicatrix after trauma in 6 patients (33%). One patient each (6% each) had retraction from graft-versus-host disease, after blepharoplasty, and after orbicularis oculi myectomy for blepharospasm. At a mean of 10 months follow-up, presenting symptoms resolved or improved in 17 patients (94%) and remained unchanged in 1 patient (6%). Midpupil to upper eyelid distance, lagophthalmos, and superficial punctuate keratopathy all improved significantly (all p < 0.001). No surgical complications occurred.


CONCLUSIONS
Graded full-thickness anterior blepharotomy is a safe, effective, and rapid technique for patients with symptomatic upper eyelid retraction due to etiologies other than Graves eye disease. This technique improves symptoms and signs of ocular exposure while addressing relative upper eyelid height symmetry and contour.
Demirci
Hakan
H
Department of Ophthalmology, University of Michigan, Ann Arbor, Michigan, USA.
Hassan
Adam S
AS
Reck
Stephen D
SD
Frueh
Bartley R
BR
Elner
Victor M
VM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019882:Blepharoplasty / Q000379:methods*; D005141:Eyelid Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005143:Eyelids / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006111:Graves Disease / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged