Year : 1984 | Volume
: 32 | Issue : 5 | Page : 371--372
Surgical treatment of thyroid related upper eyelid retraction
Department of Ophthalmology, TN Medical College & B. YL Nair Hospital, Mumbai, India
31, Pentacle, Near,Sophia College, B. Desai Road, Mumbai-400 026
|How to cite this article:|
AshokR. Surgical treatment of thyroid related upper eyelid retraction.Indian J Ophthalmol 1984;32:371-372
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AshokR. Surgical treatment of thyroid related upper eyelid retraction. Indian J Ophthalmol [serial online] 1984 [cited 2021 Sep 17 ];32:371-372
Available from: https://www.ijo.in/text.asp?1984/32/5/371/27514
Endocrine Ophthalmopathy usually is associated with hyperthyroidism, but it can also occur in euthroid & even hypothyroid person as well. Clinical changes progress from upper lid retraction, and exophthalmos through soft tissue involvement and proptosis to extraocular muscle involvement, finally the cornea is involved and vision is lost through optic nerve disease.
Local treatment of endocrine ophthalmolpathy includes the instillation of an antibiotic-decongestant, preparation, and the use of local adrenergic blocking agents, particularly guanathedine eye drops. When careful control of thyroid dysfunction and other measures including high dose steroids have failed, plastic surgery techniques are available to correct lid retraction.
MATERIAL AND METHOD
42 consecutive upper lid retraction in patients with thyroid ophthalmology where medical treatment tailed to control the disease, Muller's muscle excision with or without recession of the levator aponeurosis was tried.
The procedure is illustrated in figure A to I. Subcutaneous Inj . xylocaine 2% with adrenalin 1:1000 given over the centre of upper lid for retraction suture. Then subconjunctival Inj. Xylocaine 2% with adrenaline 1:1000 is given. Conjunctiva is separated from Muller's muscle. Then Muller's muscle is disinserted from temporal two thirds of superior tarsal border. Muller's muscle is separated from levator aponeurosis. Stripping of levator aponeurosis is done. Muller's muscle is excised. Conjunctiva is sutured back to superior tarsal border.
35 of the 42 patients yielded excellency cosmetic result The other patients had minor complications which were remedied by further surgery.
This is the preferred treatment of thyroidrelated retraction of the upper eyelid. It is relatively simple procedure that is based on the physiological and anatomical nature of the disorder. When the second upper lid is treated, several weeks after the initial operation, the lid should be placed at the same level as to which the first eylid was placed at the operation.