Lower eyelid epiblepharon associated with lower eyelid retraction.
OBJECTIVE
To describe a series of patients with lower eyelid epiblepharon associated with lower eyelid retraction.


METHODS
We retrospectively reviewed the medical records of patients who underwent surgery for lower eyelid retraction, epiblepharon, or thyroid-associated ophthalmopathy (TAO) between October 1999 and March 2007. Patients with both lower eyelid retraction and epiblepharon on preoperative examination were included in this study.


RESULTS
Twenty-seven eyelids of 20 patients with both lower eyelid retraction and epiblepharon were enrolled. The underlying causes of lower eyelid retraction included congenital retraction (seven eyelids), congenital fibrosis of the extraocular muscles (CFEOM; seven eyelids), TAO (seven eyelids), post-operative cicatricial retraction (five eyelids), and facial nerve palsy (one eyelid). Eight of 27 eyelids were successfully corrected after the repair of retraction without the repair of epiblepharon, regardless of the cause of lower eyelid retraction. Another four eyelids with epiblepharon associated with TAO resolved after only orbital decompression. Cilia-everting sutures were additionally applied for epiblepharon in another 14 eyelids, 12 of which did not require the excision of a skin fold or the orbicularis muscles. Only one eyelid with mild retraction and epiblepharon underwent simple epiblepharon repair. Recurrence of retraction or epiblepharon developed in three eyelids during follow-up.


CONCLUSIONS
In cases with both lower eyelid retraction and epiblepharon, the retraction should be repaired first, and then the epiblepharon can be corrected selectively according to the severity of the case.
Department of Ophthalmology, Inje University Sanggye Paik Hospital, Seoul, Korea.
Mi Sun
MS
Sung
Min Joung
MJ
Lee
Ho-Kyung
HK
Choung
Nam Ju
NJ
Kim
Sang In
SI
Khwarg
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005124:Eye Abnormalities / Q000150:complications* / Q000601:surgery; D005141:Eyelid Diseases / Q000150:complications* / Q000601:surgery; D005143:Eyelids / Q000002:abnormalities* / Q000601:surgery; D049970:Graves Ophthalmopathy / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult