Can Orbital Rim Implants Cause Lower Eyelid Retraction?

Q: Dr. Eppley, I am interested in orbital rim  implants. Are they dangerous? I know you do them. I have three questions: 1) Are they effective? Can they diminish hollow eyes and give them a better aesthetic look? 2) Will they cause retraction of lower eyelid? 3) Can you go blind?

A: In answer to your questions about orbital rim implants:

1) With proper design and placement they can be very effective at improving bony recession of the infraorbital rim and tear trough areas. They often, however, need to be supplemented with fat grafts in the lower eyelids to balance out the entire lower eyelid area.

2) With good surgical technique and resuspension of the lower eyelid, no. In some cases they are placed through an intraoral approach where there is no risk of lower eyelid problems at all.

3) Blindness is NOT a risk of orbital rim implants. This is a surgery that is not done on the inside of the orbital rim and would not cause any increase in intraocular pressure or injury to the optic nerve. Other than lower eyelid retraction, the biggest risk to the eye is that of a corneal abrasion if corneal protectors are not used. Or in some cases could even occur if they were used as a result of placing and removing the corneal protectors.

Dr. Barry Eppley

Indianapolis, Indiana