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Levator recession with adjustable sutures for correction of upper eyelid retraction in thyroid eye disease
Author(s) -
Ueland Hans Olav,
Uchermann Aleksander,
Rødahl Eyvind
Publication year - 2014
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.12404
Subject(s) - medicine , lagophthalmos , eyelid , surgery , ptosis , eye disease
Purpose To examine the outcome of levator muscle recession with adjustable sutures for correcting upper eyelid retraction in thyroid eye disease. Methods All patients treated at Haukeland University Hospital between 2001 and 2011 were invited to participate in a follow‐up examination. Preoperative measurements were obtained from medical records. The following parameters were recorded: eyelid aperture, the distance from limbus to eyelid margin, vertical motility of the eyelid in up‐ and downgaze, lagophthalmos, proptosis, vertical motility of the eye, and strabismus. Symmetry and eyelid contour were evaluated from photographs. Results were categorized as good, acceptable or unacceptable. Results Sixty‐four out of a total of 80 patients attended the follow‐up examination. Six were excluded from further analysis due to relapse of their thyroid eye disease with increased inflammation. Among the 58 remaining patients, a good result was observed in 34 patients, an acceptable result in 19 and an unacceptable result in 5. Lagophthalmos was seen in 30% of the lids preoperatively and in 7% postoperatively. A second procedure was performed in 13/80 patients, in 6 because of under‐correction and in 7 because of ptosis. Wound infection occurred in 2 patients. Conclusion Levator recession with adjustable sutures can be used to correct any degree of retraction. Good results can be obtained, but the procedure is time‐consuming, and patients must be informed about the risk for reoperation.