Abstract Listings 2024

Purpose

The optimal spacer to correct lower eyelid retraction in patients with thyroid eye disease (TED) remains to be identified. There are a limited number of studies, and there are no long-term follow-up studies. We have evaluated the short and long-term outcome of the use of donor sclera in correction of lower eyelid retraction in patients with TED.

Methods

All TED patients surgically treated with donor sclera to correct lower eyelid retraction at the Department of Ophthalmology, Haukeland University Hospital in the period 1999–2023 were included. Preoperative and postoperative data was obtained from hospital records. Further, a long-term clinical follow-up was performed. Outcome was graded as perfect (scleral show of ≤ 0 mm), acceptable (scleral show ≥ 1 mm).

Results

Thirty-six patients with a median age of 56 (20-79) years and a median duration of eyelid retraction of 67 (12-468) months were included. Out of these, 21 patients attended a follow-up control. For the remaining 15 patients, we utilized data from their most recent control.

Surgery was performed unilaterally in 26 and bilaterally in 10 patients. Median size of the scleral graft was 10 (6.5-14) mm in height and 20 (15-30) mm in width.

At the first control, 3 (0,3-12) months after surgery, there was a significant (p<0.001) improvement in scleral show from 2 mm (1-6) mm preoperative to 0 mm (0-6). Moreover, there was a significant (p<0.001) reduction in MRD2 from 7 (6-11) mm preoperatively to 5 (4-9) mm. At the first control, 82.7% had a perfect or acceptable result.

At final examination, 96 (20-275) months after surgery, no significant differences were observed between scleral show (2 (0-4) mm) or MRD2 (7 (5-11) mm) compared to preoperative values. A perfect or acceptable outcome was found in 40%.

Conclusion

The use of donor sclera to correct lower-eyelid retraction in patients with TED shows good results within the first year. However, over time, the retraction relapses in a significant number of patients, likely due to the shrinkage of the graft.

Additional Authors

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