2006 Papers - Lye


Reduction of palpebral bag recurrence with capsulopalpebral fascia hernia repair

Kevin D. Lye, MD, University of Hawaii Surgical Residency Program
Faculty Supervision: F. Don Parsa, MD, FACS

Background: In 1991, a prospective study was initiated to compare standard lower blepharoplasty with lipectomy on one eyelid and a modified fat-preserving capsulopalpebral fascia (CPF) hernia repair method on the contralateral side; comparable aesthetic outcomes were demonstrated after six months of follow-up. At that time it was projected that in contrast to standard lower blepharoplasty, recurrence of fat herniation, hollowing of the lower lid, and a sunken appearance of the globe would be less likely to occur with CPF hernia repair beyond this six-month period.

Methods: From 1991 to 2006, 26 patients underwent lower blepharoplasty for palpebral bags, utilizing fat removal on one side and fat preservation on the contralateral side. These patients were evaluated, and the incidence and locations of palpebral bag recurrence, lower lid hollowing, lid malposition, and eyelid dysmobility were documented.

Results: The overall recurrence rate of palpebral bags under eyes following standard fat resection (30.8%) was significantly higher than for eyes following CPF hernia repair (7.7%) (p = 0.043). Recurrences of fat herniation were found in any of the lower eyelid compartments in the former group, and only the lateral compartment in the latter.

Conclusions: In long-term follow-up, fat-preserving CPF repair for palpebral bags demonstrates superiority to standard blepharoplasty with lipectomy, with significantly lower recurrence of palpebral bags. In a small percentage of patients undergoing CPF hernia repair, limited fat resection may eliminate hernia recurrence.