Surgery for upper eyelid retraction, three techniques

Area of Science:

• Ophthalmology
• Surgical Techniques
• Eyelid Surgery

Background:

• Experience with 145 upper eyelid recession operations on 181 eyelids in 100 patients.
• Utilized three distinct surgical techniques over a 15-year period.
• Focused on adjustable sutures in upper eyelid recession surgery.

Purpose of the Study:

• To evaluate the efficacy and outcomes of three upper eyelid recession techniques.
• To assess the role of adjustable sutures in different recession procedures.
• To analyze reoperation rates and complications associated with upper eyelid retraction surgery.

Main Methods:

• Retrospective chart review of 100 patients undergoing 145 upper eyelid recession operations.
• Comparison of three techniques: prewhitnall levator recession, levator aponeurosis recession, and Henderson operation.
• Analysis of adjustable suture usage in relation to surgical technique and outcomes.

Main Results:

• Overall reoperation rate was 23%, with higher rates (24%) in thyroid eye disease patients.
• Adjustable sutures were effective in prewhitnall recessions but less so in levator aponeurosis recessions.
• The Henderson operation yielded good results with fewer procedures performed.

Conclusions:

• The prewhitnall operation is recommended for severe bilateral eyelid retraction in thyroid eye disease.
• Levator aponeurosis recession is suitable for thyroid eye disease and overcorrected ptosis.
• The Henderson operation is effective for milder degrees of eyelid retraction, with reoperation rates up to 25% considered acceptable.