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Orbital fat graft retroseptal transconjunctival blepharoplasty for treatment of groove in the infraorbital region

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Abstract

Purpose

To investigate the efficacy of the retroseptal transconjunctival blepharoplasty together with tear trough ligament (TTL) and Orbicularis retaining ligament (ORL) release with orbital fat graft in the management of groove in the infraorbital region (GIR).

Methods

A prospective study of 80 eyes of 40 patients that underwent retroseptal transconjunctival lower blepharoplasty together with TTL and ORL release and resected orbital fat grafting. An ophthalmic examination includes lower eyelid evaluation and Barton’s Tear trough deformity grading was done at baseline, 2 weeks, 3 months, and 6 months after the surgery. Patient satisfaction was evaluated using Global aesthetic improvement scale (GAIS) and Blepharoplasty outcomes evaluation (BOE).

Results

Baseline tear trough defects were graded into grade 1, 2, and 3 in 12 (15%), 39 (48.75%) and 29 (36.25%) eyes, respectively. While at 6 months follow-up, grade 0 was recorded in 63 (78.75%) eyes, and grade 1 was recorded in 17 (21.25%) eyes. The amount of fat removed was 0.52 ± 0.04 mL per eye, whereas the amount of injected fat graft was 0.24 ± 0.04. The mean operative time was 33.2 ± 4.1 min per eye. GAIS showed degree 1, 2, and 3 in 8 (20%), 29 (72.5%), and 3 (7.5%) patients at 6 months follow-up, respectively. The mean baseline BOE increased significantly from 36.5 ± 5.9 to 86.9 ± 5.5 at 6 months follow-up.

Conclusions

Our cohort highlights the beneficial effects of TTD/ORL release with resected orbital fat grafting in the management of GIR and infraorbital hollow.

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Abbreviations

TTL:

Tear trough ligament

ORL:

Orbicularis retaining ligament

GIR:

Groove infraorbital region

GAIS:

Global aesthetic improvement scale

BOE:

Blepharoplasty outcomes evaluation

HIR:

Hollowness infraorbital region

OOM:

Orbicularis oculi muscle

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Authors and Affiliations

  1. Department of Ophthalmology, Faculty of Medicine, Benha University, Benha, Qalubiya Governorate, 13511, Egypt

    Tarek Roshdy Elhamaky

  2. Department of Ophthalmology, Seha Emirates Hospital, Abu Dhabi, UAE

    Tarek Roshdy Elhamaky

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  1. Tarek Roshdy Elhamaky
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T.E. responsible for all authorship criteria. (Concepts, design, literature search, data acquisition, data analysis, statistical analysis, manuscript preparation, manuscript editing, manuscript review.)

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Correspondence to Tarek Roshdy Elhamaky.

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The authors declare that they have no conflict of interest.

Ethical approval

The local ethics committee of Seha Emirates hospital; Abu Dhabi; UAE approves this study. The study followed the tenets of the Declaration of Helsinki. ClinicalTrials.gov ID: NCT04538716.

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All patients signed an informed consent.

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Elhamaky, T.R. Orbital fat graft retroseptal transconjunctival blepharoplasty for treatment of groove in the infraorbital region. Int Ophthalmol 44, 217 (2024). https://doi.org/10.1007/s10792-024-03148-z

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