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  • Title: A review of the outcome of upper lid lowering for eyelid retraction and complications of spacers at a single unit over five years.
    Author: Fenton S, Kemp EG.
    Journal: Orbit; 2002 Dec; 21(4):289-94. PubMed ID: 12610768.
    Abstract:
    AIM: To review the outcome of upper lid lowering for eyelid retraction at a single unit over five years and to report the high complication rate with mersilene mesh as a spacer material. METHODS: We retrospectively reviewed the case records of 48 patients who underwent upper lid lowering for lid retraction between January 1995 and January 2000. RESULTS: The indication for surgery was eyelid retraction secondary to dysthyroid disease in 41 patients, seventh nerve palsy in 3 cases, overcorrection of ptosis elsewhere in 3 cases and previously treated orbital lymphoma in one patient. A good result was achieved in 80% with a single procedure. Undercorrection occurred in 10% and overcorrection occurred in 8%. Spacer material, either mersilene mesh or more recently vicryl, was used in 42% of lids. Late extrusion of mersilene mesh occurred in 20% of lids that had a spacer inserted an average of 18 months postoperatively. CONCLUSIONS: The high extrusion rate with mersilene was unacceptable and the alternative spacer material vicryl is now used. The possibility of revisional surgery because of under- or overcorrection should be explained to patients.
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