Comparison of Efficacy and Complications Among Various Spacer Grafts in the Treatment of Lower Eyelid Retraction: A Systematic Review.
BACKGROUND
Lower eyelid retraction is a difficult problem to treat, but it is a prevalent condition and a common complication of blepharoplasty. The use of spacer grafts to increase eyelid height and improve symptoms has been described for a long time, but the optimal choice of spacer graft material is unknown.


OBJECTIVE
The authors reviewed the currently available evidence to determine the best available spacer graft material in terms of efficacy and complications.


METHODS
A systematic review of all available literature published between 1985 and the present was performed using the Pubmed, Ovid MEDLINE, and Cochrane library databases. Inclusion criteria were that the studies contain original content assessing the treatment of lower eyelid retraction in humans using a spacer graft and provide quantitative outcomes data.


RESULTS
One hundred and twelve articles were reviewed following an initial screen using titles, and 19 articles were chosen for inclusion in this systematic review. Analysis of these articles revealed no spacer graft material that is clearly superior to others.


CONCLUSIONS
Due to a lack of high quality evidence, this review did not reveal one spacer graft material that is clearly superior to others. However, a narrative summary of the available evidence reveals unique sets of advantages and disadvantages associated with the various materials currently available. Further research in the form of well-designed studies will be necessary to further clarify advantages of certain spacer graft materials over others.


METHODS
5.
Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL.
Eugene
E
Park
Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL.
Kevin
K
Lewis
Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL.
Mohammed S
MS
Alghoul
D001672:Biocompatible Materials / Q000627:therapeutic use*; D001763:Blepharoptosis / Q000601:surgery; D002356:Cartilage / Q000637:transplantation; D003094:Collagen / Q000627:therapeutic use; D003228:Conjunctiva / Q000637:transplantation; D020405:Dermis / Q000637:transplantation; D005141:Eyelid Diseases / Q000209:etiology / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D006801:Humans; D009061:Mouth Mucosa / Q000637:transplantation; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012590:Sclera / Q000637:transplantation; D019737:Transplants / Q000637:transplantation*; D016896:Treatment Outcome
C440568:Alloderm; D001672:Biocompatible Materials; D003094:Collagen