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Graves Lower Eyelid Retraction.

Sara Filipa Teixeira Ribeiro1, Maria Shekhovtsova, Ana Filipa Duarte

  • 1*Department of Ophthalmology, Hospital Lusíadas Porto, Porto, Portugal; †Department of Ophthalmology, Hospital de Braga, School of Health Sciences, University of Minho, Braga, Portugal; ‡School of Medicine of Porto, University of Porto, Porto, Portugal; and §Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Hospital das Clínicas-Campus, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

Ophthalmic Plastic and Reconstructive Surgery
|January 20, 2016
PubMed
Summary

Graves lower eyelid retraction (GLLR) surgical correction lacks robust evidence. Current literature primarily describes techniques, with few controlled studies comparing spacer materials for this common Graves orbitopathy sign.

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Area of Science:

  • Ophthalmology
  • Endocrinology
  • Surgical Techniques

Background:

  • Graves lower eyelid retraction (GLLR) is a frequent and debated manifestation of Graves orbitopathy.
  • This condition involves eyelid malposition, necessitating surgical intervention.

Purpose of the Study:

  • To review the mechanisms and surgical techniques for correcting Graves lower eyelid retraction.
  • To evaluate the evidence level of existing publications on GLLR surgical correction.

Main Methods:

  • A comprehensive literature search was conducted on the MEDLINE database.
  • Keywords included "lower eyelid retraction," "Graves orbitopathy," and "eyelid surgery."
  • Publications were assessed for their level of evidence (I-IV).

Main Results:

  • Mechanisms of GLLR remain incompletely understood, with no defined subtypes.
  • The literature predominantly features technique descriptions, lacking objective outcome measurements and controlled studies.
  • Only one randomized controlled trial was identified; various spacer materials are used to lengthen lower eyelid retractors.

Conclusions:

  • A significant body of literature exists for GLLR, but controlled, randomized comparative studies are scarce.
  • The superiority of bioengineered materials over autogenous tissue for lower eyelid spacers is undetermined.
  • The impact of GLLR on lower eyelid movement and contour requires further investigation.