Repair Techniques for Failed Double-Eyelids Involving Restoration of Eyelid Anatomical Structure and Function.

Abstract

This study aimed to evaluate techniques for repairing previously failed double-eyelid surgeries based on different anatomical structure injuries. A total of 120 patients with failed double-eyelids in our hospital were enrolled and classified into four types according to their anatomical structure damage: type I, unsmooth radians of the double-eyelid line; type II, upper socket depression; type III, iatrogenic ptosis; and type IV, comprehensive damage. Accordingly, methods of restoration included orbital septum fat supplement, repair of levator palpebrae superioris, and treatment of scar. Postoperative follow-up time points were 1week, 1month, and 6months. Outcome observations were binocular symmetry, fluency of double-eyelid, scar recovery, height and contour profile of the upper eyelid margin, and plumpness of the upper eyelid. The eyelid morphological score was evaluated using photographs of preoperative and 6-month postoperative data, and the effect of eyelid repair was evaluated objectively by statistical analysis. At 1month after surgery, the height of the upper palpebral margin was maintained in most patients and located at 1-2mm below the superior limbus. At 6months after surgery, most patients had better restorative effects. Comparison of mean eyelid morphological scores showed a statistically significant improvement following surgery (P < 0.001). The technique of restoring eyelid anatomical structure in failed double-eyelids not only recovered the normal function of injured eyelids but also produced satisfactory aesthetic effects. This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .