Scientific correspondence
Autogenous hard palate mucosa: the ideal lower eyelid spacer?
Michael J Wearnea, Charles Sandya, Geoffrey E Rosea, J Pittsb, J R O Collina
a Moorfields Eye
Hospital, London, UK, b North East London Eye
Partnership, London, UK
Correspondence to: Mr Geoffrey E Rose, Adnexal Service, Moorfields Eye Hospital, City Road, London EC1V 2PD, UK
Accepted for publication 13 December 2000
BACKGROUND/AIMS
Raising
a displaced lower eyelid frequently involves recession of the lower
eyelid retractors with interposition of a "spacer," and several
materials for this purpose have been described. This study reviewed the
results of autogenous palatal mucosa in the treatment of lower eyelid
displacement, including assessment of any donor site morbidity.
METHODSA
retrospective case note review of consecutive patients treated at
Moorfields Eye Hospital between 1993 and 1998. All patients underwent
insertion of hard palate mucosa between the inferior border of the
tarsus and the recessed conjunctiva and lower eyelid retractors.
Parameters studied included the underlying diagnosis, measurements of lower lid displacement or retraction, related previous surgery, the experience of the operating surgeon,
intraoperative and postoperative complications, surgical outcome, and
length of follow up. The main outcome measure was the position of the lower eyelid relative to the globe in primary position of gaze.
RESULTS102 lower
eyelids of 68 patients were included and a satisfactory lid position
was achieved in 87/102 (85%), with inadequate lengthening or
significant recurrence of displacement occurring in 15 cases. Donor
site haemorrhage requiring treatment in the early postoperative period
occurred in seven patients (10%).
CONCLUSIONAutogenous
hard palate mucosa is an effective eyelid spacer and provides good long
term support for the lower eyelid. Donor site complications are the
main disadvantage, but may be minimised by attention to meticulous
surgical technique and appropriate postoperative management.
© 2001 by British Journal of Ophthalmology
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