Graves Lower Eyelid Retraction

Sara Filipa Teixeira Ribeiro, Maria Shekhovtsova, Ana Filipa Duarte, Antonio Augusto Velasco Cruz

Research output: Contribution to journalArticle

Abstract

PURPOSE:: Graves lower eyelid retraction (GLLR) is a common and controversial sign of Graves orbitopathy. The authors reviewed the mechanisms and surgical techniques currently used to correct this Graves orbitopathy-related eyelid malposition. METHODS:: A literature search was performed on the MEDLINE database using the keywords “lower eyelid retraction,” “Graves orbitopathy,” “thyroid ophthalmopathy,” “thyroid eye disease,” “spacers,” and “eyelid surgery.” Only articles in English were included. The level of evidence of publications regarding surgical correction of GLLR was evaluated and graded from I to IV, using a rating system adapted from a validated scientific evidence classification method. RESULTS:: The mechanisms responsible for GLLR are not fully understood and no subtypes of GLLR have been distinguished. The surgical literature of GLLR encompasses mainly descriptions of surgical techniques without objective measurements of the results, and uncontrolled studies. Only 1 randomized controlled trial was identified. To lengthen the lower retractors, a large variety of different materials have been used as spacers. CONCLUSIONS:: The scientific literature on GLLR is vast, however controlled and randomized studies comparing different surgical techniques are lacking. At the present moment it is not clear if bioengineered materials are superior to conventional autogeneous tissue as lower eyelid spacers. The effects of GLLR on lower eyelid movements and contour have not been studied.

Original languageEnglish (US)
JournalOphthalmic Plastic and Reconstructive Surgery
DOIs
StateAccepted/In press - Jan 18 2016
Externally publishedYes

Fingerprint

Eyelids
Literature
Eye Diseases
Thyroid Diseases
MEDLINE
Publications
Thyroid Gland
Randomized Controlled Trials
Databases

ASJC Scopus subject areas

  • Ophthalmology
  • Surgery

Cite this

Ribeiro, S. F. T., Shekhovtsova, M., Duarte, A. F., & Velasco Cruz, A. A. (Accepted/In press). Graves Lower Eyelid Retraction. Ophthalmic Plastic and Reconstructive Surgery. https://doi.org/10.1097/IOP.0000000000000613

Graves Lower Eyelid Retraction. / Ribeiro, Sara Filipa Teixeira; Shekhovtsova, Maria; Duarte, Ana Filipa; Velasco Cruz, Antonio Augusto.

In: Ophthalmic Plastic and Reconstructive Surgery, 18.01.2016.

Research output: Contribution to journalArticle

Ribeiro, Sara Filipa Teixeira ; Shekhovtsova, Maria ; Duarte, Ana Filipa ; Velasco Cruz, Antonio Augusto. / Graves Lower Eyelid Retraction. In: Ophthalmic Plastic and Reconstructive Surgery. 2016.
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