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Minerva Oftalmologica 2010 September;52(3):123-9

language: Italian

Palatal mucosa graft to correct inferior lid retraction in patient with endocrine orbitopaty

Tieghi R. 1, Consorti G. 1, Denes S. A. 1, Franco F. 2, Perri P. 1, Clauser L. C. 1

1 Unit of Cranio Maxillo Facial Surgery, Centre for Craniofacial Deformities and Orbital Surgery St. Anna Hospital and University, Ferrara, Italy;
2 Department of Ophthalmology, St. Anna Hospital and University, Ferrara, Italy


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Endocrine ophthalmopathy (EO) also known as Graves’ Disease is a chronic, multisystem disorder characterized by increased intraorbital fat tissue and hypertrophic extraocular muscles caused by an autoimmune process. EO may be associated with the following main clinical findings: exophthalmos, upper and lower eyelid retraction, diplopia, retrobulbar pain, chemosis, lagophthalmos, tearing, corneal ulceration resulting from the inability to close the eyelid, glaucoma, and optic neuropathy caused by the stretch on the nerve, headache. Different surgical techniques can be used: transpalpebral decompression by intraorbital fat removal (Olivari ‘s technique), three-wall bony decompression and in severe cases the complete removal of the lateral wall of the orbit (bony decompression according to Matton). The aim of surgery is to reduce endo-orbital pressure and its consequences and clinical symptoms. The authors describe the use of autogenous hard-palate mucosa as a “spacer” to lengthen and stiffen the posterior lamellae of the lower lid to correct lid retraction in patient with EO after the major surgery with satisfactory functional and cosmetic results.

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