A systematic review of the treatment of lower eyelid retraction and our attempt of a dermal-orbicularis oculi suspension flap

Lower eyelid retraction describes the inferior displacement of the lower eyelid with or without inversion or ectropion. Based on the causes of lower eyelid retraction, we divided the forming factors of lower eyelid retraction into three categories: (1) change in the balance of forces associated with the lower eyelid margin; (2) excessive loss of lower eyelid volume; (3) changes in the relative position of the eyeball and lower lid margin. In this review, the corresponding treatment methods are elaborated on individually for the above three forming factors. We also reported, for the first time, a new treatment for lower eyelid retraction. We created a dermal-orbicularis oculi suspension flap on the lateral side of the canthus and suspended it upward and inward on the dense connective tissue over the lateral bony surface of the orbital rim. The longest follow-up time was one year, and the results were satisfactory.