Our Experience of Lid Shortening (Kuhnt -Szymanowski Technique) in Lower Lid Blepharoplasty to Reduce Ectropion Formation

Abstract

Background: Lower eyelid bags, tear trough deformity and lax eye lid skin are a few aging conditions for which people seek plastic surgeon's consultation. These cosmetic concerns can be effectively addressed by lower lid blepharoplasty but this procedure alone may predispose patient to lid malpositioning and ectropion later. Including the Kuhnt Szymanowski technique with lower lid blepharoplasty, in which wedge resection of lateral posterior lamella is done, can reduce ectropion formation specially in patients with lid distraction of more than 6mm away from the globe. Objective: The objective of our study is to reduce the chances of ectropion formation and scleral show specially in elderly patients undergoing lower eyelid blepharoplasty for the correction of lower eyelid laxity and to evaluate patient's outcome. Keywords: lower eyelid blepharoplasty, lid laxity, lid distraction test, Kuhnt Szymanowski technique, ectropion Methods: This is a retrospective case series with 2 years duration from January 2019 to December 2020. All patients with lid distraction > 6mm were operated and bilateral lower lid blepharoplasty and Kuhnt Szymanowski technique was performed under L.A. Mean duration of follow-up was 6 months post-operatively and patients' surgical outcomes were assessed. Results: In our study, total 20 patients were included. Total number of eye surgeries performed were 40. Majority of patients were female (64%) were female. None of the patients (0%) reported ectropion formation post-operatively. Conclusion: In our experience, Kuhnt Szymanowski technique addresses lower eyelid laxity effectively. This technique when added in selected group of patients, reduces chances of temporary or permanent ectropion, hence reduces morbidity and redo procedures. lower eyelid blepharoplasty, lid laxity, lid distraction test, Kuhnt Szymanowski technique, ectropion.