Investigators in a recent study, published in the April 5 issue of JAMA Facial Plastic Surgery, found that coupling the lateral eyelid in patients with flaccid facial paralysis and paralytic ectropion improved ocular symptoms, eyelid appearance and quality of life.

Researchers evaluated patient-reported outcomes and photograph analysis of 16 patients with flaccid facial paralysis who underwent a single-stage tarsal strip canthoplasty and modified tarsoconjunctival flap to correct eyelid malposition.

The most commonly reported symptom, epiphora, was significantly reduced from 75% before surgery to 25% after surgery, according to the study. Lagophthalmos and scleral show also experienced substantial reductions. The Moe Ectropion Grading Scale was used before and after surgery, and 88% of patients experienced a decrease to a score of two or less. “The tarsoconjunctival flap does limit peripheral vision, but is reversible if dynamic eyelid closure is returned with nerve grafting,” researchers concluded.

Dedhia R, Hsieh T, Chin O, et al. JAMA Facial Plast Surg. April 5, 2018. [Epub ahead of print].