title: Recession and Extirpation of the Lower Eyelid Retractors for Paralytic Lagophthalmos.
abstract: OBJECTIVE
  To describe a technique to correct lower eyelid malposition and lagophthalmos due to facial nerve palsy.
  
  
  METHODS
  Chart review was performed and identified 13 patients with facial nerve palsy, who presented with paralytic eyelid malposition and were treated with recession and extirpation of the lower eyelid retractors between September 2012 and March 2014 by 1 surgeon (HBL).
  
  
  RESULTS
  A total of 12 eyelids in 11 patients met inclusion criteria. Mean preoperative MRD2 was 10 mm (range, 9.0-12.0 mm) and the mean postoperative MRD2 was 7 mm (range, 5.0-9.0 mm). The MRD2 improved an average of 3.0 mm in each patient (range, 2.0-4.0 mm). Patients had an average of 6.9 mm (range, 4.0-10.0 mm) of lagophthalmos preoperatively, which improved to 2.1 mm (range, 0.0-4 mm). The amount of lagophthalmos improved an average of 4.8 mm in the patients. There were no complications encountered in the patients. All patients had a subjective improvement in ocular comfort.
  
  
  CONCLUSIONS
  The authors' surgical technique is effective in addressing lower eyelid malposition and ocular surface disease in paralytic lagophthalmos.
authors.affiliation: *Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, Kentucky; and †Oculofacial and Orbital Surgery, Indiana University, Indianapolis, Indiana, U.S.A.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Compton
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Clark
authors.forename: William R
authors.initials: WR
authors.lastname: Nunery
authors.forename: H B Harold
authors.initials: HB
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D003228:Conjunctiva / Q000601:surgery; D004483:Ectropion / Q000209:etiology / Q000601:surgery*; D005141:Eyelid Diseases / Q000209:etiology / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005158:Facial Paralysis / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D013524:Surgical Flaps; D013536:Suture Techniques; D055815:Young Adult