Hyaluronic acid gel shows promise in managing lower eyelid retraction

A retrospective review of 31 patients with lower eyelid retraction from a variety of etiologies finds this non-surgical alternative improved measurements of scleral show.
 
Pretreatment, post-treatment, and follow-up photographs were digitized and overall outcomes were assessed. Measurements of inferior scleral show were standardized and compared.
 
The authors observed a mean change in scleral show of 1.04 mm at follow-up (mean, 6.2 months, range, 1-12 months). From initial treatment to follow-up visit (mean 4.6 months, range, 1-12 months), the effect of the hyaluronic acid gel diminished, with a mean increase in inferior scleral show of 0.52 mm. Twelve patients underwent a second treatment and improved scleral show to .87 mm. Six patients underwent a third treatment and improved to 1.13 mm.

Complications were minor: swelling, redness, bruising and tenderness at the sites of injection. The authors conclude that long-term follow-up will help better clarify frequency of maintenance injections, the degree of hyaluronic acid gel retention, and the position of the lower eyelid over time.