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Prevention of Lower Eyelid Complications Caused by a Subciliary Approach: Temporary Lower Eyelid Suspension  

Burm, Jin Sik (Department of Plastic and Reconstructive Surgery, Ewha Womans University College of Medicine)
Kim, Boo Yeong (Department of Plastic and Reconstructive Surgery, Ewha Womans University College of Medicine)
Kim, Yang Woo (Department of Plastic and Reconstructive Surgery, Ewha Womans University College of Medicine)
Publication Information
Archives of Plastic Surgery / v.33, no.4, 2006 , pp. 465-468 More about this Journal
Abstract
Purpose: Subciliary approaches to orbitozygomatic fractures have high incidence of complications such as scleral show and ectropion. Abnormal rearrangement of eyelid flaps may be a very important factor to induce abnormal cicatrical and consequent contracture. To prevent this problem, we used temporary lower eyelid suspension. Methods: A total of two hundred five patients were investigated for lower eyelid complication of orbitozygomatic fractures that underwent reconstruction with subciliary approach. The lower eyelid margin was pulled up toward the forehead using lower eyelid suspension suture to stretch the lower lid flaps. The lid suspension was maintained for one day after surgery. Results: The complications of the lower eyelid were in 15 cases(7.3%); seven cases(3.4%) of visible depressed scar, three cases(1.4%) of scleral show, two cases(1%) of ectropion, two cases(1%) of conjunctival swelling and one case(0.5%) of hematoma. Conclusions: The lower eyelid suspension seems to allow adhering lid flap in proper anatomical position and in the status of the maximal stretch and consequently preventing the severe complications such as scleral show and ectropion caused by scar contraction after subciliary approach.
Keywords
Orbital surgery; Subciliary approach; Lower eyelid suspension;
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