Treatment of postblepharoplasty lower eyelid malposition by Aptos thread.

Background: Lower eyelid malposition is the most common complication after lower eyelid blepharoplasty. Although the traditional techniques were effective for correcting lower eyelid malposition, they had potential disadvantages, including additional trauma, additional scar, and long recovery period.

Objective: To evaluate the efficacy of a minimally invasive surgical technique using Aptos thread for postblepharoplasty lower eyelid malposition.

Methods: A retrospective review of all patients undergoing lower eyelid malposition surgery via a minimal invasive, Aptos thread technique from June 2005 to June 2010. Symptoms, including epiphora, ocular irritation, conjunctivitis, and measurement of lower eyelid scleral show (measured from the inferior limbus of cornea) were recorded. Presurgery and postreconstruction photographs were reviewed for functional and cosmetic outcome.

Results: A total of 15 patients (24 eyelids) underwent successful lower eyelid malposition surgery using this minimally invasive technique. On clinical examination, all cases of lower eyelid retraction stemmed from overzealous excision of skin and orbicularis. After a follow-up interval of 12 to 25 months (mean, 15 months), inferior corneal exposure and ocular symptoms were corrected thoroughly. The decrease in lower eyelid retraction was 2.7 ± 0.9 mm. The functional and cosmetic result was satisfactory in all cases.

Conclusions: Aptos thread technique is a safe, effective, and the least invasive method of managing mild and moderate postblepharoplasty lower eyelid malposition secondary to shortening anterior lamella.