Upper eyelid retraction repair surgery in Graves’s ophthalmopathy

Abstract

Background: Graves’ ophthalmopathy (GO) is an autoimmune complex inflammatory condition affecting the eye vision and appearance cosmetically. Eyelid retraction, proptosis, limitation of extraocular muscle motility, optic nerve compression, chemosis, corneal exposure, and vessel congestion are typical ophthalmic signs and symptoms of the disease. Upper eyelid retraction is a characteristic feature of Graves’ ophthalmopathy. Surgery may help patients; surgical techniques for upper lid retraction are divided into transconjunctival Mullerectomy and transcutaneous levator aponeurosis recession. AIm: To determine the appropriate surgical method of eyelid retraction repair in Graves’ ophthalmopathy. Materials and Methods: The study included 26 eyes of 18 patients (age range 34-54) with upper eyelid retraction. Upper eyelid retraction by levator aponeurosis recession was performed in 17 eyes of 9 patients, and Mullerectomy was performed in 9 patients with one eye eyelid retraction. Results: On measurement seven days after the operation, the mean of upper eyelid retraction was 0.25±0.34 mm, and MRD1 was 4.13±0.53 mm with statistically significant (P<0.001). However, when comparing the measurements postop seven days, one month, and three months after surgery, there was no statistical significance (P>0.05) or difference. There was no difference between müllerectomy and levator aponeurosis recession surgery in eyelid retraction and MRD1 measurements. Conclusion: Müllerectomy and recession of levator aponeurosis surgery are effective in correcting the eyelid retraction symptoms prevalent in Graves’ ophthalmopathy. It has been shown that choosing the surgical method according to the condition of the eyelids and whether one or both eyes are involved is more favorable to the patient.