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Novel surgical approach to refractory eyelid imbrication

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Abstract

Eyelid imbrication, or override of the upper eyelid onto the lower lid, is usually an acquired condition associated with floppy eyelid syndrome, or a congenital but benign and self-limited syndrome. A case of severe eyelid imbrication, refractory to commonly-advocated treatments aimed at reducing horizontal lid laxity and ectropion, is presented and a novel surgical approach described: a periosteal flap, extending from the inner aspect of the superolateral orbital rim to the anterior tarsus, together with levator advancement improved apposition of the upper eyelid margin to the globe, resolved the imbrication, and reduced vertical tarsal tilt. The patient experienced complete resolution of her symptoms.

Level of evidence: Level V, therapeutic study.

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Authors and Affiliations

  1. Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA

    Jessica A. Kraker, Andrea A. Tooley & Lilly H. Wagner

  2. Moorfields Eye Hospital & Institute of Ophthalmology, London, England

    Geoffrey E. Rose

Authors
  1. Jessica A. Kraker
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  2. Andrea A. Tooley
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  3. Geoffrey E. Rose
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  4. Lilly H. Wagner
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Contributions

Lilly Wagner, Andrea Tooley and Geoffrey Rose contributed to conception of the study. Jessica Kraker and Lilly Wagner completed data collection. The first draft of the manuscript was written by Jessica Kraker and all authors edited previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Lilly H. Wagner.

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Ethical approval

The study adhered to the principles of the Declaration of Helsinki. Institutional Review Board Approval was not needed for this single case study.

Informed consent

Informed consent for clinical photography and research publication was obtained.

Conflict of interest

Jessica A. Kraker, Andrea A. Tooley, Geoffrey E. Rose, and Lilly H. Wagner declare no conflict of interest.

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Kraker, J.A., Tooley, A.A., Rose, G.E. et al. Novel surgical approach to refractory eyelid imbrication. Eur J Plast Surg 45, 333–336 (2022). https://doi.org/10.1007/s00238-021-01933-y

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  • DOI: https://doi.org/10.1007/s00238-021-01933-y

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