J Korean Ophthalmol Soc.  2018 Sep;59(9):803-809. 10.3341/jkos.2018.59.9.803.

Clinical Characteristics of Xanthelasma Palpebrarum and Clinical Effects of Upper Blepharoplasty with Local Flap Technique

• Lee SM
• Lew H

• KMID: 2420327
• DOI: http://doi.org/10.3341/jkos.2018.59.9.803

Abstract

PURPOSE
To evaluate the clinical characteristics of xanthelasma palpebrarum as well as surgical results of upper blepharoplasty with a local flap technique.
METHODS
We conducted a retrospective cross-sectional study including 12 patients who underwent removal of xanthelasma palpebrarum and upper blepharoplasty with the local flap technique from January 2010 to December 2017.
RESULTS
A total of 18 eyelids of 12 patients were included in this study. The average age was 47.0 years and three patients (25.0%) were male and the other nine patients (75.0%) were female. There were seven patients (58.3%) on both sides of xanthelasma palpebrarum, and five patients (41.7%) on one side. There was hyperlipidemia in four patients (33.3%), hypertriglyceridemia in two patients (18.2%), and hyper-low density lipoproteinemia in two patients (18.2%). Two patients had recurrence and the same surgery was performed. There was no postoperative complication. All patients were satisfied except for asymmetry in the postoperative end, and overall postoperative satisfaction was 83.3% (10/12 patients).
CONCLUSIONS
Xanthelasma palpebrarum often develops in both upper eyelids in middle-aged or older patients. Upper blepharoplasty with a local flap technique for the treatment of xanthelasma palpebrarum is an effective treatment for patients, especially in cases of ptosis or blepharochalasis. However, it should be noted that asymmetry of eyelids may occur after the surgery when surgery is performed on only one side.

Keyword

Local flap technique; Upper blepharoplasty; Xanthelasma; Xanthelasma palpebrarum

MeSH Terms

Blepharoplasty*
Cross-Sectional Studies
Eyelids
Female
Humans
Hyperlipidemias
Hyperlipoproteinemia Type II
Hypertriglyceridemia
Male
Postoperative Complications
Recurrence
Retrospective Studies

Figure

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  Figure 1. Intraoperative photographs of upper blepharoplasty with local flap technique. (A) Incision of local flap. (B) Flap rotation. (C) Adjustment of flap to cover the defect. (D) Apposition of flap margin. (E) Sutured flap. (F) Upper blepharoplasty.

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  Figure 2. Photographs of patients. (A) Preoperative photograph of 67-year old woman. (B) Postoperative photograph of 67-year old woman. (C) Preoperative photograph of 47-year old man. (D) Postoperative photograph of 47-year old man.

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  Figure 3. Algorithm for management of patient with xanthelasma palpebrarum. The underlying medical condition, size and location of the lesion should be considered in treatment of xanthelasma palpebrarum. LDL = low density lipoprotein; IHD = ischemic heart disease; TCA = trichloroacetic acid.

Reference

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