Lower eyelid splinting: An alternative to the Frost suture.

OBJECTIVES

To describe a new method of postoperative eyelid suspension used for the prevention of eyelid malposition and to report its efficacy through an outcome study.

STUDY

DESIGN

An outcome study was performed on 10 patients who would potentially need postoperative eyelid suspension. Candidates included patients with entropion, ectropion, or orbital fractures requiring transconjunctival approaches. Patients were photographed pre- and postoperatively and followed for signs of eyelid malposition.

METHODS

At the conclusion of the surgical procedure, a sheet of Xeroform gauze was folded into 6 overlapping layers and cut to conform to the shape of the inferior orbital rim. The superior edge of the gauze was sutured to the lower eyelid using interrupted 5-0 nylon suture. Sutures were placed at the medial and lateral canthi to raise the eyelid above the inferior limbus and along the inferior orbital rim. The splint was removed between postoperative days 7 and 14.

RESULTS

There were no perioperative complications related to the surgery or placement of the splint. No cutaneous marks persisted after healing. No complications such as shifting of the splint, ocular damage, or recurrent eyelid malposition occurred. One patient had asymptomatic restriction of lower eyelid elevation on upward gaze, which resolved at 6 months.

CONCLUSIONS

The lower eyelid splint appears effective in maintaining lower eyelid position postoperatively. There were no complications with its use, and the splint was tolerated well. Benefits of the splint over the Frost suture include less risk of corneal abrasion, ability to check visual function, and ability to use the splint bilaterally.