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Preaponeurotic fat advancement flap prevents unintended eyelid creases in levator recession

Use of a preaponeurotic fat advancement flap was found to be an effective method for preventing unintended multiple lid creases and providing satisfactory outcomes with levator recession, according to recently published study findings.

In a retrospective, comparative case study, researchers reviewed data for 57 eyelids of 44 Asian patients who underwent levator recession surgery with or without a preaponeurotic fat advancement flap. Thirty-one eyelids were included in a preaponeurotic fat advancement flap group and 26 eyelids were included in a non-flap group.

The researchers recorded comparisons between the two groups in terms of marginal reflex distance 1, palpebral fissure, upper palpebral fissure, pretarsal show eyelid symmetry and cosmetic complications and assessed lid position outcomes and cosmetic complications.

Among patients in the flap group, the researchers graded lid position outcomes as good in 16 patients, fair in four patients and poor in two patients. In the no-flap group, 15 patients’ lid position outcomes were rated as good, five were rated as fair and two were rated as poor.

In the no-flap group, six eyelids developed multiple lid creases postoperatively, whereas no patient developed this result in the flap group, according to the researchers.

The researchers noted six eyelids in the no-flap group that showed evidence of overcorrection, whereas only one was reported in the flap group.

Levator recession performed without the preaponeurotic fat advancement flap yielded multiple lid creases or a higher lid crease compared with those performed with the preaponeurotic fat advancement flap, according to the researchers.

No between-group differences were noted with regard to the ability to achieve acceptable eyelid lowering and eyelid symmetry, the researchers reported. - by Abigail Sutton

Disclosure: The researchers report no relevant financial disclosures.