Purpose

The aim of this case report is to evaluate the applicability of tarsal plate autograft spacer in lower eyelid retraction repair surgery, with a primary focus on healing quality and aesthetic outcome.

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Methods

A 57-year-old woman with Graves’ orbitopathy presented with complaints of lower eyelid droop and palpebral asymmetry. 18 months ago, the patient underwent medial orbital decompression. Lower eyelid retraction was corrected with a tarsal plate spacer and lateral canthopexy. Left lower eyelid lift was performed using an ipsilateral upper eyelid tarsal autograft under local anesthesia. The technical aspects of the procedure were observed during the operation, including correct tarsal plate graft retrieval, accurate placement and fixation to the surrounding tissues, and lateral canthopexy. Postoperative evaluations included monitoring of healing and palpebral symmetry during the six-month recovery period.

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Results

The procedure successfully lifted the lower eyelid of the left eye without complications. During healing, the patient experienced increased dryness in the operated eye and a slightly bothersome foreign body sensation. Within six months, the patient’s dryness decreased and the foreign body sensation disappeared. During the follow-up period, the condition of the eyelid remained unchanged and the patient is satisfied with the aesthetic aspect compared to the preoperative evaluations.

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Conclusion

Lower eyelid retraction is a relatively common complication in patients with Graves’ orbitopathy. Graves’ disease is not the only cause of lower eyelid retraction. Lower eyelid retraction surgery can be performed with various types and materials of spacers, however, tarsal plate autograft has both functional and material priorities in mild to moderate eyelid retraction.

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Additional Authors

First name	Last name	Base Hospital / Institution
Alina	Lisnova	Riga East University Hospital

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