title: Correction of Lower Eyelid Retraction Using Acellular Human Dermis During Orbital Decompression.
abstract: OBJECTIVE
  To investigate the surgical outcome of grafting acellular human dermis compared with concurrent lower eyelid retractor recession during swinging eyelid orbital decompression for correction of lower eyelid retraction in patients with Graves' orbitopathy.
  
  
  METHODS
  Institutional Review Board-approved retrospective nonrandomized study of 54 Graves' orbitopathy patients (95 eyes) from 2008 to 2012. Patients who received decompression were divided into 3 groups: Group 1 with conjunctival lengthening using 0.3-mm thickness AlloDerm (36 eyes), Group 2 with inferior retractor recession (33 eyes), and Group 3 with decompression only (26 eyes). Outcome measures included lower eyelid height, inferior sclera show, cosmetic appearance, and complications.
  
  
  RESULTS
  Baseline clinical characteristics and the degree of improvement of exophthalmos were not different between groups. Preoperative MRD2 was higher in group 1 (8.0 mm) than in groups 2 (6.9 mm, p < 0.001) and 3 (6.6 mm, p < 0.001). Mean improvement of MRD2 as well as postoperative improvement of inferior scleral show at postoperative 4 to 6 months were significantly higher in group 1 (2.7 mm) than in groups 2 (1.8 mm, p < 0.001) and 3 (1.2 mm, p < 0.001).
  
  
  CONCLUSIONS
  Simultaneous correction of lower eyelid retraction using thin AlloDerm during swinging eyelid orbital decompression maximizes improvement of lower eyelid retraction compared with concurrent inferior retractor recession.
authors.affiliation: *Department of Ophthalmology, Severance Hospital, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea; †Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea; and ‡Department of Endocrinology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kang Yoon
authors.initials: KY
authors.lastname: Kim
authors.forename: Young Jun
authors.initials: YJ
authors.lastname: Woo
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Jang
authors.forename: Eun Jig
authors.initials: EJ
authors.lastname: Lee
authors.forename: Jin Sook
authors.initials: JS
authors.lastname: Yoon
mesh_terms: D062088:Acellular Dermis; D000328:Adult; D000368:Aged; D019882:Blepharoplasty / Q000379:methods*; D019299:Decompression, Surgical / Q000379:methods*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D049970:Graves Ophthalmopathy / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult