Lower eyelid retraction describes the inferior displacement of the lower eyelid with or without inversion or ectropion.Based on the causes of lower eyelid retraction,we divided the forming factors of lower eyelid retr...Lower eyelid retraction describes the inferior displacement of the lower eyelid with or without inversion or ectropion.Based on the causes of lower eyelid retraction,we divided the forming factors of lower eyelid retraction into three categories:(1)change in the balance of forces associated with the lower eyelid margin;(2)excessive loss of lower eyelid volume;(3)changes in the relative position of the eyeball and lower lid margin.In this review,the corresponding treatment methods are elaborated on individually for the above three forming factors.We also reported,for the first time,a new treatment for lower eyelid retraction.We created a dermal-orbicularis oculi suspension flap on the lateral side of the canthus and suspended it upward and inward on the dense connective tissue over the lateral bony surface of the orbital rim.The longest follow-up time was one year,and the results were satisfactory.展开更多
Dear Sir, I am Dong Hyun Ji, from the Department of Ophthalmology of St. Vincent’s Hospital, Suwon, Korea. I write to present a very severely recurrent basal cell carcinoma (BCC) in lower lid invading left orbit and ...Dear Sir, I am Dong Hyun Ji, from the Department of Ophthalmology of St. Vincent’s Hospital, Suwon, Korea. I write to present a very severely recurrent basal cell carcinoma (BCC) in lower lid invading left orbit and whole hemiface,展开更多
AIM:To report the clinical outcomes of utilizing a three-layer flap and graft in reconstruction of the lower lid in one session.METHODS:Seventeen patients with total or near total lower eyelid defect were included.The...AIM:To report the clinical outcomes of utilizing a three-layer flap and graft in reconstruction of the lower lid in one session.METHODS:Seventeen patients with total or near total lower eyelid defect were included.The defects were reconstructed in three layers.Posterior lamella was reconstructed by using tarsoconjunctival free graft from the ipsilateral upper lid and periosteal flap from lateral orbital rim.Mobilization of residual orbicularis muscle provided a rich blood supply;and the anterior lamella was reconstructed by skin flap prepared from upper lid blepharoplasty as a one-pedicular or bipedicular bucket handle flap.RESULTS:The cause of lower eyelid defect was basal cell carcinoma in 15 patients and trauma in two of them.No intraoperative and postoperative complication occurred.Patients were followed from 10 to 15mo postoperatively.Cosmetic results were favorable in all patients and we had acceptable functional results.Thickness of the reconstructed tissue was a concern in early postoperative period.CONCLUSION:Three-layer lower lid reconstruction in one session is an effective technique for total lower lid reconstruction with minimal complications and acceptable functional and aesthetic outcomes and can be considered as a safe alternative for the preexisting techniques.展开更多
<strong>Background:</strong> Aging changes to the lower eyelids and midface include all but not only these changes: pseudoherniated orbital fat, tear trough deformity, lid laxity, and dermatochalasis. Surg...<strong>Background:</strong> Aging changes to the lower eyelids and midface include all but not only these changes: pseudoherniated orbital fat, tear trough deformity, lid laxity, and dermatochalasis. Surgical repair often aims at treating redundant skin or orbital fat malposition with a lower eyelid blepharoplasty. In manipulating the inferior orbital fat pads, a surgeon has many options including excision, repositioning, or augmentation with synthetic dermal filler, autologous fat grafts, or acellular dermal allografts <a href="#ref1">[1]</a>. The aim of this study is to find the best approach in preventing fat herniation reccurnce in lower lid blepharoplasty. <strong>Methods: </strong>The patients in study were classified into three groups depending on the used surgical technique, to test the most effective technique associated with minimal rate of lower fat pad recurrence after surgery. Two of these techniques include a muscular flap suspension from the orbicularis oculae muscle. <strong>Results: </strong>The two surgical techniques that include orbicularis oculi muscle suspension are associated with no recurrence of lower herniated fat pads after blepharoplasty. <strong>Conclusions:</strong> The suspension of orbicularis oculi muscle has an important role in enhancing the lower orbital septum and prevents the recurrence of the lower herniated fat pads.展开更多
基金The study was sponsored by the Natural Science Foundation of Shanghai(grant no.19ZR1430100)the National Natural Science Foundation of China(grant no.81871576).
文摘Lower eyelid retraction describes the inferior displacement of the lower eyelid with or without inversion or ectropion.Based on the causes of lower eyelid retraction,we divided the forming factors of lower eyelid retraction into three categories:(1)change in the balance of forces associated with the lower eyelid margin;(2)excessive loss of lower eyelid volume;(3)changes in the relative position of the eyeball and lower lid margin.In this review,the corresponding treatment methods are elaborated on individually for the above three forming factors.We also reported,for the first time,a new treatment for lower eyelid retraction.We created a dermal-orbicularis oculi suspension flap on the lateral side of the canthus and suspended it upward and inward on the dense connective tissue over the lateral bony surface of the orbital rim.The longest follow-up time was one year,and the results were satisfactory.
文摘Dear Sir, I am Dong Hyun Ji, from the Department of Ophthalmology of St. Vincent’s Hospital, Suwon, Korea. I write to present a very severely recurrent basal cell carcinoma (BCC) in lower lid invading left orbit and whole hemiface,
文摘AIM:To report the clinical outcomes of utilizing a three-layer flap and graft in reconstruction of the lower lid in one session.METHODS:Seventeen patients with total or near total lower eyelid defect were included.The defects were reconstructed in three layers.Posterior lamella was reconstructed by using tarsoconjunctival free graft from the ipsilateral upper lid and periosteal flap from lateral orbital rim.Mobilization of residual orbicularis muscle provided a rich blood supply;and the anterior lamella was reconstructed by skin flap prepared from upper lid blepharoplasty as a one-pedicular or bipedicular bucket handle flap.RESULTS:The cause of lower eyelid defect was basal cell carcinoma in 15 patients and trauma in two of them.No intraoperative and postoperative complication occurred.Patients were followed from 10 to 15mo postoperatively.Cosmetic results were favorable in all patients and we had acceptable functional results.Thickness of the reconstructed tissue was a concern in early postoperative period.CONCLUSION:Three-layer lower lid reconstruction in one session is an effective technique for total lower lid reconstruction with minimal complications and acceptable functional and aesthetic outcomes and can be considered as a safe alternative for the preexisting techniques.
文摘<strong>Background:</strong> Aging changes to the lower eyelids and midface include all but not only these changes: pseudoherniated orbital fat, tear trough deformity, lid laxity, and dermatochalasis. Surgical repair often aims at treating redundant skin or orbital fat malposition with a lower eyelid blepharoplasty. In manipulating the inferior orbital fat pads, a surgeon has many options including excision, repositioning, or augmentation with synthetic dermal filler, autologous fat grafts, or acellular dermal allografts <a href="#ref1">[1]</a>. The aim of this study is to find the best approach in preventing fat herniation reccurnce in lower lid blepharoplasty. <strong>Methods: </strong>The patients in study were classified into three groups depending on the used surgical technique, to test the most effective technique associated with minimal rate of lower fat pad recurrence after surgery. Two of these techniques include a muscular flap suspension from the orbicularis oculae muscle. <strong>Results: </strong>The two surgical techniques that include orbicularis oculi muscle suspension are associated with no recurrence of lower herniated fat pads after blepharoplasty. <strong>Conclusions:</strong> The suspension of orbicularis oculi muscle has an important role in enhancing the lower orbital septum and prevents the recurrence of the lower herniated fat pads.
