Lacrimoplasty: a new bone fixation technique for recurrent lacrimal gland prolapse

Abstract

Lacrimal gland prolapse is an often ignored and undiagnosed condition in patients seeking blepharoplasty. Recognition and correct treatment can avoid poor outcomes in such cases. Traditional techniques of treating the prolapsed lacrimal gland include light cautery, partial excision, and periosteal suture fixation. A few series of lacrimal gland prolapse have been published in the literature. But a literature search failed to reveal any reports on the recurrence of surgically treated lacrimal gland prolapse. We report the incidence of lacrimal gland prolapse purely based on the external deformity and also report a case of recurrence following surgical lacrimal gland periosteal hitching, in a patient with blepharochalasis syndrome 4 years post the original correction. A new technique of true bony fixation of the recurrent prolapsed lacrimal gland to the lacrimal fossa is described. We call the new technique 'lacrimoplasty'. An operative video is also included to demonstrate the technique step by step.

Level of Evidence: level V, therapeutic study.