Abstract ID: 26-271
Contour-Preserving Orbital Fat Decompression with ORL Release Improves Lower Eyelid Position and Inferior Scleral Show
Author: Kihei Yoshida Base Hospital / Institution: Oculo Facial Clinic Group
Presentation Type: ePoster Presentation
Purpose
To evaluate a novel, contour-preserving approach to aesthetic orbital fat decompression that incorporates orbicularis retaining ligament (ORL) release and grafting of the resected orbital fat. The study specifically focuses on the technique’s ability to reduce proptosis while simultaneously improving lower eyelid position and correcting inferior scleral show.
Methods
A retrospective review was conducted on 17 consecutive patients (34 eyes) with non-thyroidal proptosis who underwent aesthetic orbital fat decompression. The surgical technique involved selective excision of inferomedial and lateral orbital fat, while central lower orbital fat was strictly preserved to maintain posterior globe support. The resected autologous orbital fat was then grafted into the midface area following ORL release. Preoperative and 3-month postoperative measurements included Hertel exophthalmometry, margin reflex distance 2 (MRD2), and inferior scleral show. Data were analyzed eye-by-eye using paired t-tests.
Results
The mean volume of resected orbital fat was 2.8 mL (range, 1.3–7.1 mL). Hertel measurements significantly decreased from a mean of 19.5 mm to 16.7 mm (mean reduction, 2.8 mm; p < 0.001). Notably, lower eyelid position improved, with MRD2 decreasing from 6.5 mm to 5.8 mm (mean improvement, 0.7 mm; p < 0.001). Inferior scleral show also significantly decreased from 0.48 mm to 0.12 mm (mean improvement, 0.36 mm; p < 0.001). No significant changes in visual acuity or major complications were observed.
Conclusion
This contour-preserving approach successfully achieved significant proptosis reduction while improving lower eyelid apposition. Unlike conventional decompression, which often risks postoperative globe ptosis and a resultant hollowed appearance, the preservation of central fat maintains essential structural support. Combined with ORL release and autologous fat grafting, this technique effectively balances volume reduction with anterior lamellar support, enhancing both functional and aesthetic outcomes in patients with proptosis.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Tomoyuki | Kashima | Oculo Facial Clinic Group |