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Acellular Dermal Allografts for Lower Eyelid Retraction Correction: A Systematic Review and Single-Arm Meta-Analysis
Jorge Klagges1, Iqbal Sayudo2, Andrea Marcon3
1From the Division of Ophthalmology, University of Chile, Santiago, Chile.
Annals of Plastic Surgery
|February 2, 2026
Summary
Acellular dermal allografts effectively correct lower eyelid retraction, improving margin reflex distance 2 and reducing scleral show. Complication rates are low, demonstrating safety for this procedure.
Area of Science:
- Ophthalmology
- Plastic Surgery
- Regenerative Medicine
Background:
- Lower eyelid retraction stems from various factors including neurogenic, myogenic, mechanical, and congenital causes.
- The efficacy and safety of acellular dermal allografts for lower eyelid retraction require further investigation.
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness of acellular dermal allografts in correcting lower eyelid retraction.
- To assess key outcomes such as margin reflex distance 2 (MRD2) and inferior scleral show (ISS) improvement.
Main Methods:
- A comprehensive search of major databases (PubMed, Embase, Scopus, Cochrane) was conducted.
- Included studies focused on acellular dermal allografts for lower eyelid retraction correction.
- Statistical analysis involved meta-analysis of MRD2, ISS, complications, and reoperation rates.
Main Results:
- Fifteen studies with 330 participants (413 eyelids) were analyzed.
- Significant improvements were observed in MRD2 (2.12 mm) and ISS (2.21 mm).
- Low complication (8.97%) and reoperation (0.04%) rates were reported, with granulomas being a common complication.
Conclusions:
- Acellular dermal matrix grafts are effective for correcting lower eyelid retraction.
- The procedure demonstrates a favorable safety profile for eyelid reconstruction.
- These findings support the use of acellular dermal allografts in managing lower eyelid retraction.
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