Nonsurgical Treatment of Cicatricial Ectropion with Hyaluronic Acid Filler

Abstract

Cicatricial lower eyelid ectropion is caused by a shortening of the anterior lamella, with resultant eversion of the eyelid away from the globe. Treatment is typically surgical; however, the author hypothesized that a nonsurgical injection of hyaluronic acid filler could stretch the tethered skin and act as a tissue expander to correct the lid. Fifteen patients with lower eyelid cicatricial ectropion were injected with a hyaluronic acid filler below the surface of the affected eyelid skin. The patients were followed prospectively for over 1 year for outcomes and complications. All patients achieved immediate and dramatic correction of their ectropion with a single injection. Eleven patients (73 percent) had complete correction lasting more than 1 year and four had partial correction. No major complications were observed; however, temporary bruising and a Tyndall effect was evident in a majority of patients. Hyaluronic acid filler injections can successfully treat cicatricial ectropion by expanding the tethered anterior lamella of the skin. This provides an effective alternative to surgical correction of the lid. The treatment is quick, safe, and easy to learn.