J Korean Ophthalmol Soc.  2011 Feb;52(2):136-140.

Correction of Lower Lid Retraction Using Autologous Ear Cartilage Graft

• Yoon C
• Kim N
• Lee MJ
• Choung H
• Pahn MS
• Khwarg SI

Abstract

PURPOSE
To evaluate the surgical results of lower eyelid retraction using autologous ear cartilage graft.
METHODS
Fifty patients (54 eyes) who received surgical correction of lower eyelid retraction by lower eyelid retractors and conjunctiva recession from the tarsal plate with autologous ear cartilage grafts from March 2002 to July 2010 were evaluated. Medical records were reviewed and clinical characteristics, surgical outcomes, and postoperative complications were analyzed retrospectively.
RESULTS
The use of prosthesis due to anophthalmos or microphthalmos (22 eyes) was the most common cause of lower eyelid retraction. The mean postoperative follow-up period was 16.6 months (1-98 months). Lower eyelid retraction was successfully corrected in 52 of 54 eyes. Postoperatively, 2 cases of corneal erosions, 1 case of conjunctival erosion, and 2 pyogenic granulomas developed. Corneal and conjunctival erosions resolved with conservative management and granulation tissues were removed by excision.
CONCLUSIONS
Correction of lower eyelid retraction using autologous ear cartilage graft is an excellent surgical procedure with low complication rates for eyelid retraction of various etiologies.

Keyword

Ear cartilage; Lower eyelid retraction; Spacer

MeSH Terms

Anophthalmos
Conjunctiva
Ear
Ear Cartilage
Eye
Eyelids
Follow-Up Studies
Granulation Tissue
Granuloma, Pyogenic
Humans
Medical Records
Microphthalmos
Postoperative Complications
Prostheses and Implants
Transplants

Figure

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  Figure 1. The degree of lower eyelid retraction (mm) and corresponding widths of autologous ear cartilage graft (mm) used for correction.

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  Figure 2. A 49-year-old man underwent evisceration 20 years ago and has been wearing prosthesis in his right eye. (A) Preoperatively, the patient showed lower eyelid retraction of 4 mm and upper eyelid ptosis in his right eye. (B) A photograph 6 weeks after ear cartilage graft (5 mm width) in the right lower eyelid, lateral tarsal strip, and levator reattachment procedure in the upper eyelid showing corrected lower eyelid retraction and ptosis.

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  Figure 3. A 46-year-old woman with thyroid associated ophthalmopathy. (A) Preoperatively, the patient showed right lower eyelid retraction of 5 mm and bilateral upper eyelid retraction. She had a prior history of receiving right inferior rectus recession. (B) A photograph 4 months after ear cartilage graft (5 mm width) in the right lower eyelid, and 1 month after levator recession in both upper eyelids showing corrected lower and upper eyelid retractions.

Reference

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