This is a systematic review of published literature on the management of lacrimal gland prolapse or ptosis. The authors found 16 publications which contained a description of any surgical correction of a prolapsed lacrimal gland, comprising seven case reports, four case series, four retrospective studies and one prospective study, between 1979 and 2021. However, four studies had no follow-up data and five had no report of possible complications. In total there were 483 patients who all underwent an upper lid blepharoplasty combined with some form of lacrimal gland re-suspension. Ninety percent had direct suturing of the gland to the periosteum of the lacrimal fossa, the vast majority with a non-absorbable suture. 9.7% had shrinkage by cautery of the capsule for small degrees of prolapse (<4mm), and one patient had transposition of Whitnall’s ligament. Follow-up when reported ranged from one month to five years, (mean 18 months). Only five patients developed recurrent prolapse of the 455 evaluated for it, and two out of 313 evaluated developed persistent dry eye. The authors conclude that although many of the studies were of low quality, surgical resuspension of the lacrimal gland appears to be a safe and reliable procedure with a recurrence rate of around 1%.
Surgical correction of lacrimal gland prolapse
Reviewed by James Hsuan
Correction of lacrimal gland ptosis in blepharoplasty: a systematic review.
