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Surgery for upper eyelid retraction, three techniques

R G Small

    Transactions of the American Ophthalmological Society
    |January 1, 1995
    PubMed
    Summary
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    This study evaluated three upper eyelid recession techniques, finding the prewhitnall operation effective for thyroid eye disease. Reoperation rates were acceptable, with adjustable sutures showing varied success.

    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.

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  • 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.