Abstract
Purpose: :
To evaluate the clinical outcomes of transeyelid internal browpexy using resorbable fixation.
Methods: :
50 patients with mild to moderate brow ptosis and dermatochalasis underwent transblepharoplasty internal browpexy using resorbable subperiosteal endotines. Each case was evaluated for total operative time, surgical complications, and patients were examined at post–operative day 7 and (at least) months 3, 6 and 9 for photographic documentation, discomfort, palpability of endotines, brow position and post–operative healing.
Results: :
Total operative time was increased by approximately 6 minutes per side. Surgical complications (intra–operative hematoma) occurred in 1/50 cases (2%). All 50 patients had at least 6 months of follow–up. 13 were male (26%) and 37 female (74%). Ages ranged from 34–76 (mean 52). 15/50 (30%) received 3.0 mm endotines and 35/50 (70%) received 3.5 mm endotines. At 6 months, 14/50 (28%) had mild brow elevation (all with motility <15mm and without thick brows), 4/50 (8%) had brow drop (3 male, 1 female, all had 3.0 mm endotines, thick brows and motility >15 mm), 32/50 (64%) had stable brow position, and all patients were able to palpate the endotines (palpability by physician and patient resolved in all patients by 9 months). At 3 months, the endotine implant was visible by patient and surgeon in 34/50 (64%). 29/50 (58%) noted discomfort with direct palpation of brow and frontalis muscle use (resolved by 3 months in 20/29 (69%) and by 6 months in remaining 9/29).
Conclusions: :
The placement of resorbable endotine implants via the subperiosteal transblepharoplasty approach may be safely accomplished with minimal additional operative time and appears to be a useful technique for internal brow fixation in the majority of patients.
Keywords: eyelid • anatomy • comparative anatomy