Hard Palate Mucosa Grafts for Lower Lid Retraction

ABSTRACT

Lower eyelid retraction is usually managed by recession of the lower lid retractors and interposition of a spacer graft including ear cartilage, nasal septal cartilage, donor sclera or autogenous tarsoconjunctiva.We have used hard palate mucosa as a spacer in 10 patients (11 eyelids)with lower lid retraction.Average age at operation was 36 years with the range of 10 years to 59 years.Causes of the lower lid retraction were thyroid ophthal-mopathy (4 eyelids), strabismus surgery (2 eyelids), entropion repair (2 eye-lids), eyelid infection (2 eyelids), and trauma (1 eyelid).Of 11 eyelids, 7 eye-lids were combined with entropion due to the shortage of posterior lamella. The follow-up period ranged from 3 to 45 months (mean 17 months).Surgi-cal results in all 11 eyelids were satisfactory.There was no complication in donor site.Hard palate closely approximates lower lid tarsus in terms of contour, thickness, and stiffness, provides a mucosal surface and shows only minimal shrinkage. We suggest hard palate mucosal grafts as one of the best available spacer material for the treatment of lower lid retraction.