Management of Tear Trough deformity with and without Orbicularis retaining ligament release in blepharoplasty : A comparative study / Engy Abdeltawab Ahmed ; Supervised Yehia Salah Eldin Mostafa , Tamer Ismail Gawdat , Youmna Amr Abdelwahab

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Ophthalmology

Purpose : Evaluation of the effect of releasing the Tear trough- orbicularis retaining ligament complex combined with the classic blepharoplasty in the surgical management of tear trough deformity compared with the effect of classic blepharoplasty alone Methods: A prospective, randomized(by closed envelope technique) ,controlled surgical trial which included 50 patients (100 eyes) with bilateral visible tear trough deformity and lower eyelid fat bulging,divided in two groups where 25 patients (50eyes)had tear trough {u2013}orbicularis retaining ligament release and 25 patients (50eyes)didn{u2019}t with classic blepharoplasty,qualitative and quantitative assessment of tear trough deformity and was done at 6 months postoperatively,achieving grade 0 or 1 of barton's classification was considered as success rate. - Standardized photographic documentation of each patient was done pre and postoperatively, also assessment of the patients satisfaction postoperatively from (excellent- very good {u2013}good- fair) according to the improvement in the perioebital rejuvenation. Results: There was statistically significant difference between the two groups in the overall aesthetic results postoperatively regarding the qualitative and quantitative analysis of the tear trough deformity, where patients who had Tear trough {u2013}ORL complex release had more successful outcomes than those of the second group. Conclusion Orbicularis retaining ligament release should be done in all patients candidate for blepharoplasty in order to release the teathering effect of this ligament which leads to the prominence of the naso jugal groove

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