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Objective: Among the surgical procedures used to correct the positions of the eyelids or improve their cosmetic appearance, procedures for treating eyelid retraction are some of the most challenging. Lower eyelid retraction can occur iatrogenically after various surgical procedures. We performed a successful corrective procedure for lower eyelid retraction, which had occurred at some point in the 2 decades after primary surgery for epiblepharon. Method: A 23-year-old woman underwent primary surgery for bilateral epiblepharon at the age of 5 years. However, at the age of 17, she noticed that an abnormally large proportion of her right sclera was visible when her eyes were in their natural position. In the primary position of gaze, the distance from the lower limbus of the right cornea to the upper margin of the lower eyelid was approximately 2 mm. An incision was made in the lower eyelid along the scar caused by the previous operation. Subsequently, the connections between the tarsus and the lower eyelid retractors were broken, and harvested auricular cartilage was placed between the lower edge of the tarsus and the lower eyelid retractors. Results: One year after the operation, there was no gross difference in the distance between the lower margin of the corneal limbus and the lower eyelid on either side, and the patient was extremely happy with the results. Conclusion: Using a novel surgical technique, we successfully lengthened the posterior layer of the lower eyelid retractors with a small amount auricular cartilage, resulting in good functional and cosmetic outcomes. [ABSTRACT FROM AUTHOR]

Background: Various materials are used to reconstruct cranial defects. The present study focuses on what happens when reconstructed skulls are impacted in trauma situations. Using biomechanical analysis, the present study elucidates how the hardness of reconstruction material affects the vulnerability of reconstructed skulls., Methods: A 3-dimensional finite element model was produced simulating the skull of an intact adult male. A defect was made on the left hemi-frontal part of the skull model. The defect was restored with artificial bone with 3 different hardness models. These models were respectively defined as Hard Model (simulating reconstruction with titanium), Moderate Model (simulating reconstruction with a material equivalent to human bone), and Soft Model (simulating reconstruction with hydroxyl apatite). Virtual impacts were applied on these models in 9 patterns, and the conditions of subsequent fracture were evaluated using finite element analysis. For each of the 9 impact patterns, the conditions of subsequent fracture were compared among the 3 models., Results: In 8 of the 9 impact patterns, the condition of fracture was more widespread for Hard Model than for Moderate Model and Soft Model., Conclusions: Skulls reconstructed with a hard material can develop serious fracture if they are impacted again. Therefore, usage of hard materials should be avoided to prevent serious injuries from secondary trauma., (© 2022, HMP Global. All rights reserved. Reproduction in whole or in part prohibited. Content may not be reproduced in any form without written permission. Rights, Permission, Reprint, and Translation information is available at www.hmpglobal.com.)

Objective: Among the surgical procedures used to correct the positions of the eyelids or improve their cosmetic appearance, procedures for treating eyelid retraction are some of the most challenging. Lower eyelid retraction can occur iatrogenically after various surgical procedures. We performed a successful corrective procedure for lower eyelid retraction, which had occurred at some point in the 2 decades after primary surgery for epiblepharon., Method: A 23-year-old woman underwent primary surgery for bilateral epiblepharon at the age of 5 years. However, at the age of 17, she noticed that an abnormally large proportion of her right sclera was visible when her eyes were in their natural position. In the primary position of gaze, the distance from the lower limbus of the right cornea to the upper margin of the lower eyelid was approximately 2 mm. An incision was made in the lower eyelid along the scar caused by the previous operation. Subsequently, the connections between the tarsus and the lower eyelid retractors were broken, and harvested auricular cartilage was placed between the lower edge of the tarsus and the lower eyelid retractors., Results: One year after the operation, there was no gross difference in the distance between the lower margin of the corneal limbus and the lower eyelid on either side, and the patient was extremely happy with the results., Conclusion: Using a novel surgical technique, we successfully lengthened the posterior layer of the lower eyelid retractors with a small amount auricular cartilage, resulting in good functional and cosmetic outcomes.