INTRODUCTION: Lower eyelid malposition is one of the most common complications following lower eyelid blepharoplasty. This may take the form of a mild scleral show with the round eye syndrome or may progress to frank ectropion in some patients. OBJECTIVE: This study intended to systematically approach inferior lid malposition based on the severity and ethiopatogeny of each case. METHODS: Inferior lid retraction was divided in 3 groups based on severity and ethiopatogeny that would guide the treatment. Group 1 had inferior displacement of the lid only on the canthal/ lateral aspect. Canthoplasty was performed in this group; Group 2 included retraction confined to the medial and lateral aspect of the lower eyelid with involvement of medial and/or anterior lamella but with no ectropion. Drill hole canthoplasty with tarsal strip and release of posterior lamellar scaring. Group 3 included patients with 2 or more lamella involved and ectropion. In this group, a Drill hole canthoplasty with tarsal strip, release of posterior lamellar scaring and hard plate mucosa spacer graft was performed. RESULTS: The used approach effectively corrected the inferior lid malposition with release of the referred symptoms. CONCLUSION: Appropriate surgery, which is determined on the basis of the preoperative evaluation, has allowed for the correction of these previously difficult-to-treat lower eyelid malposition with minimal complications. Despite successful correction a pre operative evaluation is paramount to avoid complications in the lower eyelid surgery.
Ectropion; Blepharoplasty
