Abstract
Patients with Gravesʼ orbitopathy often develop eyelid changes. These may be the result
of a volume effect or a malposition. Both dermatochalasis with fat tissue increase
and eyelid retraction may lead to functional or aesthetic impairment. The present
article reviews indications, timing and principles for corrective eyelid surgery.
If at all possible, surgical eyelid correction in Gravesʼ orbitopathy should be performed
once the disease became inactive and stabile. Surgical details of eyelid lengthening
procedures for upper and lower eyelid retraction are presented. Meanwhile anterior
blepharotomy became the primary procedure for upper eyelid lengthening. However, there
is no such standard procedure for lower eyelid lengthening, although it is recommended
to use a spacer. For blepharoplasty it is mandatory to distinguish between orbital
fat prolapse and subbrow fat pad. A prolapse of the lacrimal gland should not be missed
and generally, skin excision performed
sparingly.
Key words
Gravesʼ orbitopathy - eyelid retraction - blepharotomy - spacer - blepharoplasty
