Anterior lamellar repositioning with complete lid split: a modified method for treating upper eyelids trichiasis in Asian patients

SummaryAnatomically, the upper eyelids of an Asian are considerably unique, and nearly half of the East Asians have single eyelids. This study presents a new, modified, Asian-specialised procedure to simultaneously treat trichiasis and dermatochalasis. It combines anterior lamellar repositioning with lid split surgery and blepharoplasty, and creates a completely penetrating anterior lamellar flap so as to fully shift the anterior lid margin upwards. Between May 2004 and May 2006, 114 cases (144 eyelids) were operated and followed-up for at least 12 months. Lid margin and eyelash position, improvement of symptoms, recurrence rate, overcorrection and aesthetic appearance were assessed at each visit. Of the 144 eyelids operated, the recurrence rate was 0% at 3 months, 2.8% at 6 months and 5.6% at 12 months. There was no case of secondary lid ectropion or retraction, and the aesthetic alterations were accepted by all the patients. In conclusion, the modified operation – anterior lamellar repositioning with complete lid split – is an effective, personalised method for the treatment of upper eyelids trichiasis in Asian patients.