Lower eyelid reverse ptosis repair

Area of Science:

• Ophthalmology
• Oculoplastics
• Reconstructive Surgery

Background:

• Lower eyelid reverse ptosis can obscure the pupillary axis, particularly in downgaze, impacting visual function like reading.
• Causes of lower eyelid reverse ptosis are diverse, including involutional changes, post-surgical alterations (orbital decompression, retinal or extraocular muscle surgeries), and trauma.

Purpose of the Study:

• To evaluate the efficacy and safety of surgical repair for lower eyelid reverse ptosis.
• To assess the outcomes of transcutaneous advancement of the lower eyelid retractors in patients with this condition.

Main Methods:

• A retrospective case series involving eight patients (31-77 years old) with lower eyelid reverse ptosis.
• Surgical intervention involved transcutaneous advancement of the lower eyelid retractors, performed on 12 eyelids.
• Patient data, including eyelid fissure measurements and symptom resolution, were analyzed post-surgery.

Main Results:

• Significant improvement in mean vertical eyelid fissure height from 6.2 mm to 7.7 mm.
• Mean distance between the central light reflex and lower eyelid margin increased from 1.7 mm to 3.3 mm, indicating improved eyelid position.
• All patients reported symptom improvement with no perioperative complications observed during a mean follow-up of 9 months.

Conclusions:

• Transcutaneous advancement of the lower eyelid retractors is an effective and safe surgical method for correcting lower eyelid reverse ptosis.
• This technique provides functional and aesthetic improvements, analogous to upper eyelid ptosis repair.
• The procedure offers a reliable solution for visual impairment caused by lower eyelid malposition.