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February 1971

Correction of the Superior Lid Sulcus With Subperiosteal Implants

Author Affiliations

From the Department of Ophthalmology, University of Pennsylvania and Frankford Hospital, Philadelphia.

Arch Ophthalmol. 1971;85(2):188-190. doi:10.1001/archopht.1971.00990050190012

THE DEVELOPMENT and presence of the superior lid sulcus remains as one of the most common complications following enucleation surgery.

There are several theories which postulate the reasons for its occurrence. Among them are the following: (1) atrophy of orbital fat which may or may not be combined with displacement of the orbital implant; (2) shifting of the orbital contents downward due to gravity—the shift also occurs posteriorly due to tissue elasticity; (3) malpositioning of the superior rectus muscle—its attachment to the levator causes the levator to pull posteriorly rather than superiorly; and (4) unrecognized orbital floor fractures.1,2

In general, techniques for correction have included subperiosteal cartilage implants, dermal grafts, fascia lata implants, synthetic orbital implants made of plastic polytef (Teflon), or silicone and glass beads.3-5

My objective in the treatment of a superior lid sulcus defect is to fill orbital volume from below and thus selectively displace

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