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Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
A modified posterior approach for upper eyelid retraction.
Audrey L G Looi1, Basant Sharma, Peter J Dolman
1Department of Ophthalmology and Visual Sciences, University of British Columbia, Canada.
Ophthalmic Plastic and Reconstructive Surgery
|November 23, 2006
Summary
This study presents an effective graded technique for lowering retracted upper eyelids, achieving good results even in severe cases. The posterior approach using hot-wire cautery offers a safe and efficient surgical option.
Area of Science:
- Ophthalmology
- Oculoplastic Surgery
Background:
- Upper eyelid retraction can cause significant functional and aesthetic issues.
- Surgical correction is often necessary to restore normal eyelid position and function.
Purpose of the Study:
- To describe and review a graded surgical technique for lowering the upper eyelid via a posterior approach.
- To evaluate the efficacy and safety of this technique, including Müller muscle and levator aponeurosis manipulation and hot-wire cautery dissection.
Main Methods:
- A 10-year retrospective chart review of 99 patients (161 eyelids).
- Telephone interviews were conducted for patient satisfaction where follow-up was less than 6 months.
- Statistical analysis included an unpaired t test.
Main Results:
- 89% of eyelids achieved the target margin reflex distance (MRD1) of 4 ± 1 mm after one procedure.
- The mean follow-up was 61 months, with minimal complications reported.
- Mean operative time was 16 minutes per eyelid, with good preservation of upper eyelid contour.
Conclusions:
- The described posterior approach technique is effective for correcting upper eyelid retraction, including severe cases.
- The use of hot-wire cautery is beneficial for reducing operative time.
- The procedure demonstrates a favorable safety profile with well-preserved eyelid aesthetics.
