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

ABSTRACT

BACKGROUND: This study aimed to evaluate techniques for repairing previously failed double-eyelid surgeries based on different anatomical structure injuries. METHODS: 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 1 week, 1 month, and 6 months. 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. RESULTS: At 1 month after surgery, the height of the upper palpebral margin was maintained in most patients and located at 1-2 mm below the superior limbus. At 6 months after surgery, most patients had better restorative effects. Comparison of mean eyelid morphological scores showed a statistically significant improvement following surgery (P < 0.001). CONCLUSIONS: 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. LEVEL OF EVIDENCE IV 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 .