J Korean Ophthalmol Soc.  2012 Mar;53(3):357-364.

Nonsurgical Treatment of Abnormal Eyelid Position Using Hyaluronic Acid Gel

• Chung SJ
• Shin HM
• Lew H

Abstract

PURPOSE
The present study investigated the outcomes of nonsurgical treatment of abnormal eyelid position using hyaluronic acid gel.
METHODS
Abnormal eyelid position including 18 eyes with lid retraction, 10 eyes with lagophthalmos, and 18 eyes with ectropion were treated with hyaluronic acid gel. The mean age was 50 +/- 17.8 years and the mean observation period was 11 +/- 2.4 months. The photographs of patients were taken before injection, 1 month, 4 months, and at the last follow-up after injection. The marginal reflex distance 1 (MRD1) and marginal reflex distance 2 (MRD2) of patients were measured and analyzed by the Image J Program. The severity of ectropion was graded by a scoring system.
RESULTS
Ten eyes with lagopthalmos improved 1.9 +/- 1.2 mm after injection. The 16 eyes with lid retraction improved 1.3 +/- 0.9 mm. Twenty-three eyes with ectropion improved and 17 eyes (81%) were completely corrected. The average frequency of injection was 1.1 and the average dose of injection was 0.4 +/- 0.12 cc. No significant complications were observed in any patient.
CONCLUSIONS
Hyaluronic acid gel injections can be used safely and effectively as a nonsurgical treatment for patients with abnormal eyelid position without any significant complications.

Keyword

Ectropion; Hyaluronic acid gel; Lagopthalmos; Lid retraction; Nonsurgical treatment

MeSH Terms

Ectropion
Eye
Eyelids
Follow-Up Studies
Humans
Hyaluronic Acid
Reflex
Hyaluronic Acid

Figure

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  Figure 1 Schematic image of locations of hyaluronic acid gel injection. (A) Image of upper lid. (B) Image of lower lid.

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  Figure 2 Examples of patients with lagopthalmos, before and after treatment with hyaluronic acid. Case 2, 81 year-old female with left lagopthalmos. (A) Before injection, (B) 4 months after injection. Case 3, 50 year-old female, with left paralytic lagopthalmos (C, D). Case 4, 39 year-old female, with right lagopthalmos. (E) Before injection, (F) 6 months after injection.

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  Figure 3 Examples of patients with lid retraction, before and after treatment with hyaluronic acid gel injection. Case 2, 15 year-old female, after primary closure of lowerlid laceration. (A) Before injection, (B) 5 months after injection. Case 7, 58 year-old female, after Lower lid blepharoplasty who has injury of facial laceration. (C) Before injection, (D) 6 months after injection. Case 8, 11 year-old female, with lid retraction. (E) Before injection, (F) 6 months after injection.

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  Figure 4 Examples of patients with ectropion, before and after treatment with hyaluronic acid. Case 3, 45 year-old male, with left paralytic ectropion. (A) Before injection, (B) 5 months after injection. Case 5, 72 year-old female, with left facial palsy. (C) Before injection, (D) 3 months after injection. Case 12, 70 year-old male, after lower blepharoplasty. (E) Before injection, (F) 8 months after injection.

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