A Procedure to Minimize Lower Lid Retraction During Large Inferior Rectu Receion in Grave Ophthalmopathy

Purpoe To determine whether complete detachment of the facia of the capulopalpebral head during large inferior rectu receion can help to prevent induced lower lid retraction in Grave ophthalmopathy. Deign Retropective conecutive cae erie. Method Data from patient (39 eye) with Grave ophthalmopathy undergoing inferior rectu receion were collected retropectively. Inferior rectu receion wa performed by limbu-baed inciion with adjutable uture. imultaneou detachment of the facia of the capulopalpebral head wa achieved by harp diection and evering of the facia. Inferior rectu receion with imultaneou detachment of the facia of the capulopalpebral head wa performed in 27 eye and without detachment in 12 eye. Margin reflex ditance (MRD2) wa documented preoperatively and 3 month potoperatively. Reult Of the 39 eye included in thi tudy, four eye with preexiting lower lid retraction in the detachment group improved after urgery. Eighteen eye in the detachment group exhibited the ame MRD2 value, and only five eye howed increaed MRD2 value. In contrat, all but one of the 12 eye in the nondetachment group howed increaed MRD2 value. The average change in the MRD2 value 3 month after urgery wa 0.04 ± 0.59 mm in the detachment group and 1.58 ± 0.73 mm in the nondetachment group. There wa a tatitically ignificant difference between the two group (P < .01). Concluion imultaneou detachment of the facia of the capulopalpebral head during inferior rectu receion can minimize the poibility of lower lid retraction.