J Cosmet Med 2020; 4(2): 64-68  https://doi.org/10.25056/JCM.2020.4.2.64
Surgical treatment of epiphora with eyelid retraction after a lower eyelid surgery
Jae Hun Lee, MD, Nam Yeong Kim, MD, Hee Bae Ahn, MD, PhD
Department of Ophthalmology, Dong-A University College of Medicine, Busan, Rep. of Korea
Hee Bae Ahn
E-mail: hbahn@dau.ac.kr
Received: September 7, 2020; Revised: November 15, 2020; Accepted: December 4, 2020; Published online: December 31, 2020.
© Korean Society of Korean Cosmetic Surgery. All rights reserved.

cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Because of the rapidly increasing demand for cosmetic surgery in Korea, the number of patients presenting with epiphora after lower eyelid surgery and diagnosed with retraction is currently increasing.
Objective: To evaluate the effect of the lateral tarsal strip procedure (LTS) in patients with epiphora and eyelid retraction after lower eyelid surgery.
Methods: A total of 145 eyes of 81 patients who reported to our hospital between January 2010 and February 2020 were included in the study. Twenty-six eyes of 17 patients underwent LTS, and 119 eyes of 64 patients underwent LTS combined with silicone tube intubation or endonasal dacryocystorhinostomy (DCR). The pre- and postoperative symptoms, margin reflex distance 2 (MRD2), tear meniscus height (TMH), and complications were retrospectively compared.
Results: Seventy-two of the 81 patients (88.9%) showed improvements in epiphora. The improvements in TMH in the combined surgery and single surgery groups were 0.45±0.28 and 0.44±0.18 mm, respectively, showing postoperative improvements in both groups. MRD2 also improved to 0.62±0.66 and 0.27±0.68 mm in the combined surgery and single surgery groups, respectively. No significant difference was observed between the two groups.
Conclusion: LTS is an effective surgical method for epiphora in patients experiencing eyelid retraction after lower eyelid surgery. Its combination with silicone tube intubation or endonasal DCR is considered effective for lacrimal pathway disorders.
Keywords: endonasal dacryocystorhinostomy; epiphora; eyelid retraction; lateral tarsal strip; silicone tube intubation
  1. Rosenstock T, Hurwitz JJ. Functional obstruction of the lacrimal drainage passages. Can J Ophthalmol 1982;17:249-55.
  2. Vick VL, Holds JB, Hartstein ME, Massry GG. Tarsal strip procedure for the correction of tearing. Ophthalmic Plast Reconstr Surg 2004;20:37-9.
    Pubmed CrossRef
  3. Jones LT. Epiphora: its causes and new surgical procedures for its cure; a preliminary report. Am J Ophthalmol 1954;38:82431.
  4. Jones LT. An anatomical approach to problems of the eyelids and lacrimal apparatus. Arch Ophthalmol 1961;66:111-24.
    Pubmed CrossRef
  5. Vallabhanath P, Carter SR. Ectropion and entropion. Curr Opin Ophthalmol 2000;11:345-51.
    Pubmed CrossRef
  6. Anderson RL. Tarsal strip procedure for correction of eyelid laxity and canthal malposition in the anophthalmic socket. Ophthalmology 1981;88:895-903.
  7. Anderson RL, Gordy DD. The tarsal strip procedure. Arch Ophthalmol 1979;97:2192-6.
    Pubmed CrossRef
  8. Jordan DR, Anderson RL. The lateral tarsal strip revisited. The enhanced tarsal strip. Arch Ophthalmol 1989;107:604-6.
    Pubmed CrossRef
  9. Nowinski TS, Anderson RL. The medial spindle procedure for involutional medial ectropion. Arch Ophthalmol 1985;103:1750-3.
    Pubmed CrossRef
  10. Ryu WY, Suh JY, Ahn HB. Lateral tarsal strip procedure and silicone tube intubation on the functional nasolacrimal duct obstruction. J Korean Ophthalmol Soc 2010;51:1174-8.
  11. Lemke BN, Cook BE Jr, Lucarelli MJ. Canthus-sparing ectropion repair. Ophthalmic Plast Reconstr Surg 2001;17:161-8.
    Pubmed CrossRef
  12. Doane MG. Blinking and the mechanics of the lacrimal drainage system. Ophthalmology 1981;88:844-51.
  13. Jones LT. Epiphora. II. Its relation to the anatomic structures and surgery of the medial canthal region. Am J Ophthalmol 1957;43:203-12.
  14. Jones LT, Linn ML. The diagnosis of the causes of epiphora. Am J Ophthalmol 1969;67:751-4.
  15. Hill JC. Treatment of epiphora owing to flaccid eyelids. Arch Ophthalmol 1979;97:323-4.
    Pubmed CrossRef
  16. Liu D, Stasior OG. Lower eyelid laxity and ocular symptoms. Am J Ophthalmol 1983;95:545-51.
  17. Bick MW. Surgical management of orbital tarsal disparity. Arch Ophthalmol 1966;75:386-9.
    Pubmed CrossRef
  18. Cannon PS, Sadiq SA. Can eyelid taping predict the benefit of a lateral tarsal strip procedure in patients with eyelid laxity and functional epiphora? Ophthalmic Plast Reconstr Surg 2009;25:194-6.
    Pubmed CrossRef
  19. Becker BB. Tricompartment model of the lacrimal pump mechanism. Ophthalmology 1992;99:1139-45.
  20. Chung WS, Park NG. Functional obstruction of the lacrimal draings system. J Korean Ophthalmol Soc 1995;36:1435-8.
  21. Wormald PJ, Tsirbas A. Investigation and endoscopic treatment for functional and anatomical obstruction of the nasolacrimal duct system. Clin Otolaryngol Allied Sci 2004;29:3526.
    Pubmed CrossRef

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