PMID: 18427627Apr 23, 2008Paper

The graded levator hinge procedure for the correction of upper eyelid retraction (an American Ophthalmological Society thesis).

Transactions of the American Ophthalmological Society
Daniel P Schaefer

Abstract

Many surgical techniques have been developed to address eyelid retraction with varying results. Identifying and evaluating the anatomical and pathophysiological factors involved will assist in its surgical treatment. This prospective study evaluated the graded levator hinge procedure, in combination with a Müllerectomy and/or lateral canthoplasty when indicated, in an attempt to precisely and selectively target the pathophysiology responsible for the various causes of eyelid retraction in only one surgical session. This is a clinical, prospective study of patients with moderate to severe eyelid retraction due to various causes who underwent the graded levator hinge procedure, in combination with a Müllerectomy and/or lateral canthoplasty when indicated. The exact amount of hinging of the levator aponeurosis, and combination with a Müllerectomy and/or lateral canthoplasty, was determined by the clinical operative findings with active cooperation from the conscious patient. Thirty-two consecutive patients (48 eyelids) with varying degrees of upper eyelid retraction underwent the graded levator hinge procedure in combination with a Müllerectomy and or lateral canthoplasty when indicated. The mean (+/- standard deviation) preoperat...Continue Reading

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