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Updated: Jul 8, 2026

Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Lower eyelid position after transconjunctival lower blepharoplasty with versus without a skin pinch
Mehryar Taban1, Mehran Taban, Julian D Perry
1Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Purpose:
To evaluate the effect of transconjunctival lower blepharoplasty with or without a skin pinch on lower eyelid position.
Methods:
Retrospective analysis of patients undergoing bilateral lower blepharoplasty using a transconjunctival approach with or without a skin pinch. Patients undergoing other surgical procedures that could affect lower eyelid position were excluded. Twenty-five patients (50 eyes) underwent transconjunctival blepharoplasty without skin pinch and 20 patients (40 eyes) underwent transconjunctival blepharoplasty with a skin-pinch technique. Preoperative and postoperative photographs were measured for the horizontal corneal diameter and distance from light reflex to lower eyelid margin (MRD2). The ratio of MRD2 to corneal diameter was multiplied by 11 to standardize to a corneal diameter of 11 mm. Student t test was used for statistical analysis.
Results:
There were 8 male and 37 female patients. Average follow-up was 4 months. Mean preoperative standardized MRD2 was 4.68 mm and 4.65 mm for transconjunctival blepharoplasty without and with skin pinch, respectively. Mean postoperative standardized MRD2 was 4.73 mm and 4.70 mm for transconjunctival blepharoplasty without and with skin pinch, respectively. The mean change in lower eyelid position was 0.05 mm after each technique. The change in lower eyelid position was not statistically significant for either group (p > 0.5). There was no significant difference in lower eyelid position change between the 2 groups (p > 0.99).
Conclusions:
Transconjunctival lower blepharoplasty with or without a skin pinch yields a stable postoperative lower eyelid position.
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