Abstract
Purpose :
Lower eyelid retraction causes discomfort, tearing, and permanent damage to the cornea. Surgery typically requires selecting a spacer graft to support long-term elevation of the eyelid, each with its own set of advantages and disadvantages. This study compares the outcomes of lower eyelid retraction repair with 3 types of grafts: acellular dermal matrix, autologous auricular cartilage, and autologous hard palate mucosa.
Methods :
An IRB-approved, HIPAA compliant, retrospective review was conducted in patients undergoing lower eyelid retraction repair with one surgeon (AB) using either of the three aforementioned spacer grafts between January 2015 and November 2019. Patients were identified through the hospital electronic medical records, using the Current Procedural Terminology (CPT) code for lower eyelid retraction repair. Patient demographics, etiology of lower lid retraction, and eyelid height (margin to reflex distance 2) were recorded pre-operatively, at post-operative visit 1, at post-operative month 6, and at the most recent post-operative visit.
Results :
85 patients were identified to have undergone lower eyelid retraction repair with either acellular dermal matrix, autologous auricular cartilage, or autologous hard palate mucosa. Of these, 52 used acellular dermal matrix, 26 used autologous auricular cartilage, and 7 used autologous hard palate mucosa. Margin to reflex distance 2 at the preoperative visit, first postoperative visit, and most recent postoperative visit were not statistically different between the three groups. Average number of days from the date of surgery to the most recent postoperative visit was 310 days overall and was not statistically different between groups.
Conclusions :
Among patients randomized to 3 types of spacer grafts for lower eyelid retraction repair, outcomes were not statistically significant different when the 3 groups were compared. This allows choice of spacer graft type based solely on surgeon and patient preferences.
This is a 2020 ARVO Annual Meeting abstract.