A Novel Percutaneous Surgical Approach Using Silicone Sheets for Lower Eyelid Lengthening: A Descriptive Case Series

Area of Science:

• Ophthalmology
• Oculoplastic Surgery

Background:

• Lower eyelid lengthening is crucial for correcting eyelid retraction.
• Eyelid retraction can compromise ocular surface integrity, leading to inflammation and corneal damage.

Purpose of the Study:

• To evaluate the efficacy of a novel percutaneous surgical technique using a silicone sheet for lower eyelid elongation.
• To minimize ocular surface inflammation and corneal damage in patients with lower eyelid retraction.

Main Methods:

• A case series of 15 patients (22 eyelids) with lower eyelid retraction.
• Novel silicone-sheet-based lower eyelid elongation surgery performed by a single surgeon.
• Preoperative and postoperative measurements of corneal epithelial damage and margin reflex distance-2.
• Assessment of ocular surface discharge and foreign body sensation via patient interviews.

Main Results:

• Mean margin reflex distance-2 decreased from 7.17 to 5.89 mm over a mean follow-up of 31.9 months.
• Superficial punctate keratopathy resolved within 1 month post-surgery.
• Ocular discharge and foreign body sensation significantly decreased within days of surgery.
• No recurrence or complications were observed.

Conclusions:

• The novel silicone-sheet technique shows promise for lower eyelid elongation, reducing ocular surface damage and improving outcomes.
• Further large-scale, multicenter studies are required to validate this technique for managing lower eyelid retraction.