Efficacy of allogenous fascia lata grafts in the management of lower eyelid retraction

Purpose To report on the use of allogenous fascia lata (FL) grafts in patients with lower eyelid retraction (LER). Methods In this retrospective study, a consecutive series of 27 patients (39 eyes) with LER who underwent lower eyelid elevation with FL was included. Examinations including measurement of the palpebral fissure vertical height (PFVH), the inferior scleral show distance, the margin reflex distance 2 (MRD 2), and the evaluation of conjunctival hyperemia were conducted at baseline and after a mean postoperative time of 25.9 +/- 25.5 (5.0-81.0, median 13.0, last follow-up) months in all patients. Results At the last follow-up, a significant reduction of the PFVH (11.3 +/- 1.7 versus 12.8 +/- 2.1 at baseline, p < 0.001), the inferior scleral show distance (0.7 +/- 1.0 mm versus 2.1 +/- 1.1 at baseline, p < 0.001), and the MRD 2 (6.4 +/- 0.9 versus 7.8 +/- 1.3 at baseline, p < 0.001) occurred. The conjunctival hyperemia grading score (McMonnies) was significantly reduced (1.8 +/- 0.7) at the last follow-up compared to baseline (2.6 +/- 0.6, p < 0.001). No case of ectropion or entropion was observed at the last follow-up visit. Conclusion In this case series, lower eyelid elevation with FL grafts as a spacer led to a significant reduction of the PFVH, MRD 2, inferior scleral show distance, and conjunctival hyperemia. No severe surgery-related complications occurred.