A review of the outcome of upper lid lowering for eyelid retraction and complications of spacers at a single unit over five years

Orbit. 2002 Dec;21(4):289-94. doi: 10.1076/orbi.


Aim: To review the outcome of upper lid lowering for eyelid retraction at a single unit over five years and to report the high complication rate with mersilene mesh as a spacer material.

Methods: We retrospectively reviewed the case records of 48 patients who underwent upper lid lowering for lid retraction between January 1995 and January 2000.

Results: The indication for surgery was eyelid retraction secondary to dysthyroid disease in 41 patients, seventh nerve palsy in 3 cases, overcorrection of ptosis elsewhere in 3 cases and previously treated orbital lymphoma in one patient. A good result was achieved in 80% with a single procedure. Undercorrection occurred in 10% and overcorrection occurred in 8%. Spacer material, either mersilene mesh or more recently vicryl, was used in 42% of lids. Late extrusion of mersilene mesh occurred in 20% of lids that had a spacer inserted an average of 18 months postoperatively.

Conclusions: The high extrusion rate with mersilene was unacceptable and the alternative spacer material vicryl is now used. The possibility of revisional surgery because of under- or overcorrection should be explained to patients.

MeSH terms

  • Adult
  • Aged
  • Blepharoplasty
  • Eyelid Diseases / etiology
  • Eyelid Diseases / surgery*
  • Eyelids / surgery*
  • Facial Nerve Diseases / complications
  • Female
  • Foreign-Body Migration / etiology*
  • Graves Disease / complications
  • Humans
  • Lymphoma / complications
  • Male
  • Middle Aged
  • Orbital Neoplasms / complications
  • Polyethylene Terephthalates / adverse effects*
  • Retrospective Studies
  • Surgical Mesh / adverse effects*


  • Polyethylene Terephthalates
  • Lavsan