The lower eyelid represents an exceptionally complex area. It acts as a strong foundation to protect the eye globe. Anatomically, a network of ligaments and cartilage (i.e. the tarsoligamentous sling) is draped across the lower eyelid to not only protect the cornea, but to maintain the natural appearance of the eye.
Very commonly, these natural attachments can be disrupted by age-related changes, trauma and/or repeated eyelid surgery. This can result in eyes that have difficulty closing, or excess “sclera show” meaning the white inside the lower eyelid is overly exposed. In worst case scenarios, the lower eyelid can turn outward, a process known as Ectropion, which can result in the eye becoming exposed and dry. If left uncorrected, the natural protection of the cornea can be affected, which can lead to changes in or loss of vision.
Dr. Pacella has a specialized interest in the lower eyelid. He is often consulted by other surgeons for assistance in the correction of deformities in this region. These conditions are repaired by reattaching the natural connections of the eyelid tendons, a procedure which involves special anchoring of these attachments to the bones of the orbit. At times, additional support with a tissue graft or “spacer” graft may be required.
While the procedure is highly specialized and intricate, it can be very successful in restoring your natural eyelid position and correcting problems with eyelid closure.