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A Web-Based Survey of Oculoplastic Surgeons Regarding the Management of Lower Lid Retraction |
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| Authors: | Alicia Galindo-Ferreiro Estrella Fernandez Daniel Weill Denise C M Zornoff Rajiv Khandekar Jose Eduardo Corrente |
| Affiliation: | 1. Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain;2. Department of Ophthalmology, Hospital Clínic de Barcelona, Institut Clínic d‘Oftalmologia, Barcelona, Spain;3. Department of Ophthalmology, Facultad de Medicina de Buenos Aires, Universidad de Buenos Aires, Buenos Aires, Argentina;4. Distance Education and Health Information Technology Center, Faculdade de Medicina de Botucatu, UNESP, Sao Paulo, Brazil;5. Diagnostic Research, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia;6. Department of Biostatics, Instituto de Biociencias, UNESP, Sao Paulo, Brazil |
| Abstract: | Purpose: To survey the opinion of oculoplastic surgeons on the assessment and management of lower eyelid retraction (LLR). Methods: A web-based survey queried oculoplastic surgeon members of Ojoplast, Spanish and Brazilian Oculoplastic Societies on the management of LLR. The frequency and percentage proportions of the responses were analyzed. Results: One hundred ninety-six oculoplastic surgeons participated in the survey. The main cause of LLR is post-blepharoplasty (62;31.6%). The most used sign to detect LLR is scleral show. The most common approaches to managing LLR are lateral canthal surgery (164/593;27.6%), autogenous spacers (148/593; 24.9%) and retractor release (131/593;22.1%). The preferred autogenous graft material includes ear cartilage (102/260;39.2%). The majority of surgeons (161/314; 51.3%) recommend massage or steroids injection (80/314;25.5%) for early post-blepharoplasty LLR, while, 54.1% (106/196) of participants suggested waiting for at least six months prior to surgical intervention. Frost suture is used after most LLR surgeries (154/196;91.1%). Incomplete correction is the main complication (111/310;35.8%) of LLR surgery. For mild LLR, 48% of the responders prefer clinical treatment; conversely, severe cases routinely require combined surgical techniques. Conclusions: Oculoplastic surgeons frequently diagnose LLR based on scleral show. LLR management depends on the cause and severity of lid retraction. Mild cases, in general, receive clinical treatment and severe cases need a combination of surgical techniques and grafts. |
| Keywords: | Lower eyelid retraction scleral show surgeries management |