Upper eyelid retraction in the anophthalmic socket: review and survey of the Australian and New Zealand Society of Ophthalmic Plastic Surgeons (ANZSOPS)

Abstract

PURPOSE: Unlike ptosis, upper eyelid retraction (ULR) is not a widely reported complication of the anophthalmic socket or post-enucleation socket syndrome (PESS). The clinical entity of post-enucleation ULR is investigated. METHODS: 1) Two cases of post-enucleation ULR presenting to a specialist oculoplastic center (South Australian Institute of Ophthalmology, Adelaide, Australia) are described, 2) Single forced choice survey of 22 members of the Australian and New Zealand Society of Ophthalmic Plastic Surgeons regarding their clinical experience of ULR in anophthalmia, and 3) English literature review. RESULTS: One case of ULR occurred less than 1 year and the other several decades following enucleation, both cases underwent eyelid surgery. Eighty-two percent of oculoplastic surgeons surveyed believe ULR is a rare and late (50%) complication of anophthalmia and 13.5% had never seen a case. Ninety-five percent indicated that ptosis is more common than retraction. A literature review supports the rarity of ULR in anophthalmia and a number of etiological factors are discussed. CONCLUSIONS: Upper eyelid retraction is a rare and often late complication of the anophthalmic socket. It occurs less commonly than ptosis as part of PESS, but increased recognition and reporting may improve the understanding of its true incidence and cause.