ePoster listing and sessions

Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London

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Combined Dermis Spacer Graft, Lateral Canthopexy and Subperiosteal Midface Lifting in the Management of Lower Eyelid Retraction Secondary to Chronic Facial Nerve Palsy

Author: Chafik KEILANI
ePoster Number: 212


Facial nerve paralysis (FNP) may result in a range of ocular sequelae. Lower eyelid retraction and paralytic ectropion due to FNP contributes to lagophthalmos and sight-threatening exposure keratopathy. The pathophysiology of lower eyelid retraction secondary to FNP involves lateral canthal tendon laxity, middle lamella defect, and malar descent. The aim of this study is to describe a series of patients with FNP whose lid retraction was treated with a combined dermis spacer graft, lateral canthopexy and subperiosteal midface lifting.


The study design was a retrospective non comparative case series from January 2018 to August 2019. Only consecutive patients with moderate to severe lower eyelid retraction secondary to chronic FNP (over 1 year) were included. Preoperatively, all patients were noted to have a combination of lower eyelid laxity, middle lamellar contracture, and malar descent. All patients underwent a triple procedure including a dermis spacer graft, lateral canthopexy and subperiosteal midface lifting. Preoperative and postoperative assessment included evaluation of lower eyelid position, lagophthalmos, midfacial ptosis and facial asymmetry. Follow-up was at 1 week, 1 month and 12 months, postoperatively.


All 3 patients (representing 3 retracted eyelids) had complete resolution of scleral show and were uniformly satisfied with their cosmetic and functional outcome at last follow up. Preoperative dry eye symptoms resolved in all patients in the series. There were no major complications.


The combination of dermis spacer grafting, lateral canthopexy, and midface lifting is an effective, aesthetic, and functional treatment for lower eyelid retraction resulting from FNP. This procedure is associated with a low morbidity rate, and high patient satisfaction. This technique treats the three pathophysiologic components (posterior, intermediate and anterior lamella defect) simultaneously and rehabilitates the patients cosmetically and functionally.

Additional Authors

First nameLast nameBase Hospital / Institution
MichelPAQUESQuinze-Vingt National Hospital
JulienBOUMENDILQuinze-Vingt National Hospital

Abstract ID: 20-117