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DOI: 10.1055/s-0044-1792168
Successful Treatment of Primary Eyelid Lymphedema by Periorbital Lymphovenous Anastomosis: A Case Report
Funding This research was partially supported by the Soonchunhyang University Research Fund and supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (RS-2023-00211517).
Abstract
Eyelid lymphedema is a rare condition that presents as persistent swelling and non-pitting edema of the eyelids. Treatment options for this disease are limited, including surgical debulking and medications, which do not achieve complete resolution. Few studies have demonstrated the use of lymphovenous anastomosis (LVA) in the preauricular area for eyelid lymphedema treatment. In this report, we demonstrate the successful treatment of primary eyelid lymphedema by performing multiple LVAs in the periorbital region, where dermal backflow was visualized using indocyanine green lymphography. A total of four LVAs were performed through two separate incisions at the lateral canthal area and lateral eyebrow in a patient with unilateral upper eyelid lymphedema that resulted in significant improvement without recurrence.
Keywords
lymphedema - lymphovenous anastomosis - eyelid lymphedema - facial lymphedema - lymphovenous bypassAuthors' Contributions
Conceptualization: H.G.C.
Methodology: D.Y.H, E.S.P, C.Y.C, S.M.N.
Writing—original draft: H.G.C.
Writing—review and editing: H.G.C.
Ethical Approval
This study was conducted in accordance with the principles of the Declaration of Helsinki.
Patient Consent
The patient provided written informed consent for the publication and the use of his images.
Publication History
Received: 27 February 2024
Accepted: 01 October 2024
Article published online:
27 December 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 Logan SA, Thyparampil PJ, Yen MT. Immunosuppressant-related lower eyelid edema in transplant patients. Ophthalmic Plast Reconstr Surg 2017; 33 (3S Suppl 1): S58-S60
- 2 Sagili S, Selva D, Malhotra R. Eyelid lymphedema following neck dissection and radiotherapy. Ophthalmic Plast Reconstr Surg 2013; 29 (06) e146-e149
- 3 Kim JE, Sim CY, Park AY. et al. Case series of Morbihan disease (extreme eyelid oedema associated with rosacea): diagnostic and therapeutic approaches. Ann Dermatol 2019; 31 (02) 196-200
- 4 Reddy DN, Martin JS, Potter HD. Melkersson-Rosenthal syndrome presenting as isolated eyelid edema. Ophthalmology 2017; 124 (02) 256
- 5 Bernardini FP, Kersten RC, Khouri LM, Moin M, Kulwin DR, Mutasim DF. Chronic eyelid lymphedema and acne rosacea. Report of two cases. Ophthalmology 2000; 107 (12) 2220-2223
- 6 Szuba A, Rockson SG. Lymphedema: anatomy, physiology and pathogenesis. Vasc Med 1997; 2 (04) 321-326
- 7 Parsa FD, Sickenberg M. Lymphedema of the face. Ann Plast Surg 1989; 23 (02) 178-181
- 8 Chan HY, Chan LKY, Kwok TYT, Yuen HKL. Surgical correction of persistent eyelid lymphoedema after radiotherapy: four case reports. Hong Kong Med J 2023; 29 (05) 456-458
- 9 Carruth BP, Meyer DR, Wladis EJ. et al. Extreme eyelid lymphedema associated with rosacea (Morbihan disease): case series, literature review, and therapeutic considerations. Ophthalmic Plast Reconstr Surg 2017; 33 (3S Suppl 1): S34-S38
- 10 Lai TF, Leibovitch I, James C, Huilgol SC, Selva D. Rosacea lymphoedema of the eyelid. Acta Ophthalmol Scand 2004; 82 (06) 765-767
- 11 Clodius L. Lymphedema of the eyelids. Plast Reconstr Surg 1979; 63 (01) 115
- 12 James JH. Lymphedema of the eyelids. Plast Reconstr Surg 1978; 61 (05) 703-706
- 13 Koshima I, Kawada S, Moriguchi T, Kajiwara Y. Ultrastructural observations of lymphatic vessels in lymphedema in human extremities. Plast Reconstr Surg 1996; 97 (02) 397-405 , discussion 406–407
- 14 Ayestaray B, Bekara F, Andreoletti JB. π-shaped lymphaticovenular anastomosis for head and neck lymphoedema: a preliminary study. J Plast Reconstr Aesthet Surg 2013; 66 (02) 201-206
- 15 Inatomi Y, Yoshida S, Kamizono K, Hanada M, Yasumatsu R, Kadota H. Successful treatment of severe facial lymphedema by lymphovenous anastomosis. Head Neck 2018; 40 (07) E73-E76
- 16 Mihara M, Uchida G, Hara H. et al. Lymphaticovenous anastomosis for facial lymphoedema after multiple courses of therapy for head-and-neck cancer. J Plast Reconstr Aesthet Surg 2011; 64 (09) 1221-1225
- 17 Pan WR, Le Roux CM, Briggs CA. Variations in the lymphatic drainage pattern of the head and neck: further anatomic studies and clinical implications. Plast Reconstr Surg 2011; 127 (02) 611-620
- 18 Nittner-Marszalska M, Krasnowska M, Solarewicz-Madejek K, Jedrzejuk D, Szuba A. Melkersson-Rosenthal syndrome: lymphoscintigraphy-documented impairment and restoration of facial lymphatic drainage in the course of disease. Lymphology 2010; 43 (01) 34-41
- 19 Bourgeois P, Peters E, Van Mieghem A, Vrancken A, Giacalone G, Zeltzer A. Edemas of the face and lymphoscintigraphic examination. Sci Rep 2021; 11 (01) 6444
- 20 Yamamoto T, Iida T, Matsuda N. et al. Indocyanine green (ICG)-enhanced lymphography for evaluation of facial lymphoedema. J Plast Reconstr Aesthet Surg 2011; 64 (11) 1541-1544
- 21 Pan WR, Suami H, Taylor GI. Lymphatic drainage of the superficial tissues of the head and neck: anatomical study and clinical implications. Plast Reconstr Surg 2008; 121 (05) 1614-1624