Graded Anterior Partial-thickness Blepharotomy for the Correction of Idiopathic Unilateral Upper Eyelid Retraction: A Case Report and Literature Review

Abstract

Idiopathic upper eyelid retraction is a rare ocular symptom characterized by abnormal upward displacement of the upper eyelid, often without any identifiable systemic disease. This condition not only affects the patient's appearance but may also have a certain impact on their daily life and mental health. We report a case of adult idiopathic unilateral upper eyelid retraction, and based on the patient's specific condition, we used graded anterior plate blepharoplasty for treatment. This surgical method aims to restore the normal position and facial symmetry of the eyelids by finely adjusting the eyelid tissue, especially correcting abnormalities in the levator and Miller muscles. After undergoing graded anterior plate blepharoplasty, the patient's eyelid position and facial symmetry were significantly improved. Postoperative observation showed that the patient's upper eyelid retraction symptoms were effectively corrected, and the correction effect was stable without recurrence. This study confirmed the effectiveness and safety of graded anterior lamellar blepharoplasty in the treatment of idiopathic unilateral upper eyelid retraction in an adult. This surgical method not only significantly improves the eyelid position and facial symmetry of patients but also has fast postoperative recovery and fewer complications, providing valuable insights for the management of idiopathic upper eyelid retraction.

Fig. 1.

Surgical treatment of upper eyelid ptosis. Before (A) and after (D) right graded anterior marginal levator myotomy for idiopathic unilateral upper eyelid retraction. The central levator aponeurosis was resected at the superior border of the tarsal plate medial to the lateral position of the pupil (B). The underlying Müller muscle was dissected and resected carefully, with the conjunctiva remaining intact (C). Incremental extensions of the levator myotomy were performed until ideal eyelid position was achieved.