Repair of Eyelid Retraction

  • Graves' ophthalmopathy generally causes {the} eyelids to open more widely. The front surface of {the} eyeball becomes exposed beyond {the} eyelids and causes discomfort and excessive tearing; exposure keratopathy.
  • Eyelid surgery is {the} most common surgery performed on Graves ophthalmopathy patients.
  • Lid-lengthening surgeries can be done on upper and lower eyelid to correct {the} patient’s appearance and {the} ocular surface exposure symptoms.
  • Marginal myotomy of levator palpebrae muscle can reduce {the} palpebral fissure height by 2-3 mm.
  • When there is a more severe upper lid retraction or exposure keratitis, marginal myotomy of levator palpebrae associated with lateral tarsal canthoplasty is recommended.
  • This procedure can lower {the} upper eyelid by as much as 8 mm. Other approaches include müllerectomy (resection of {the} Müller muscle), eyelid spacer grafts and recession of {the} lower eyelid retractors. Blepharoplasty can also be done to debulk {the} excess fat in {the} lower eyelid.

  • Surgically repositioning {the} eyelids can reduce {the} irritation. If orbital decompression, eye muscle and eyelid surgery are required, {the} eyelid procedure is generally performed as {the} final procedure in {the} series.

Upper Eyelid Retraction

  • The upper eyelid retraction could be worsened if {the} eye is unable to raise normally (strabismus), and extra nerve impulses are sent simultaneously to {the} muscle which elevates {the} lid and to {the} muscle struggling to raise {the} eye itself; once {the} restriction is treated (e.g. strabismus surgery), {the} degree of retraction often decreases.

Lower Eyelid Retraction


Use of {the} tarSys® for posterior lamellar grafting for lower eyelid malposition



BioElevation ▪ Amniotic Membrane ▪ tarSys


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