This article is part of Ophthalmology Advisor’s conference coverage from the 2021 Fall Scientific Symposium of the American Society of Ophthalmic Plastic and Reconstructive Surgery, held in New Orleans from November 11 to 12, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the oculoplastic researchers and other clinicians at the ASOPRS. Check back for more from the ASOPRS 2021 Fall Scientific Symposium.

Primary closure, semicircular flap, dermal matrix sandwich graft, sliding tarsal flap, and transconjunctival flap represent 5 current surgical approaches to correcting lower eyelid defects, with the choice of procedure typically determined by the size of the defect. In a poster presented at the 2021 meeting of the American Society of Ophthalmic Plastic and Reconstructive Surgery, researchers compared the efficacy of these techniques by conducting a retrospective chart review from 2005 to 2020 of 178 cases in 175 patients who required lower eyelid repair

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To minimize variability of outcomes due to the performing surgeon, all patients assessed had surgeries completed by a single surgeon. Postoperative photographs were then evaluated by 3 oculoplastic surgeons who were blinded to the type of procedure that the patient received and, in some cases, blinded to the patient’s initial defect. The evaluating surgeons assessed cosmetic results as well as postoperative deformities and the need for additional surgical interventions. Postoperative deformities assessed included margin contour, lateral canthus, short fissure, lash line, and poor lid position. Follow-up ranged from 28 to 1784 days, with 63% of patients following up for at least 90 days.

Overall, primary closure, semicircular flap, and sliding tarsal flap techniques produced superior cosmetic outcomes in almost all patients, compared with dermal matrix sandwich grafts and transconjunctival flaps. Of the assessed procedures, transconjunctival flaps were most often associated with a need for additional surgical interventions.


Visit Ophthalmology Advisor’s conference section for complete coverage of the ASOPRS 2021 Fall Scientific Symposium.



Custer P, Maamari R, Ho T, Couch S, Hardesty JF. Comparative methods of lower eyelid reconstruction. Poster Presented at: American Society of Ophthalmic Plastic and Reconstructive Surgery 52nd Annual Fall Scientific Symposium. November 11-12, 2021; New Orleans.