Clinical Characteristics of Xanthelasma Palpebrarum and Clinical Effects of Upper Blepharoplasty with Local Flap Technique

Sang Min Lee; Helen Lew

doi:10.3341/jkos.2018.59.9.803

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Lee and Lew: Clinical Characteristics of Xanthelasma Palpebrarum and Clinical Effects of Upper Blepharoplasty with Local Flap Technique

Original Article

J Korean Ophthalmol Soc 2018;59(9):803-809.

Published online: 25 September 2018

DOI: https://doi.org/10.3341/jkos.2018.59.9.803

Clinical Characteristics of Xanthelasma Palpebrarum and Clinical Effects of Upper Blepharoplasty with Local Flap Technique

Sang Min Lee, MD, Helen Lew, MD, PhD

Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Korea

Address reprint requests to Helen Lew, MD, PhD Department of Ophthalmology, CHA Bundang Medical Center, #59 Yatap-ro, Bundang-gu, Seongnam 13496, Korea Tel: 82-31-780-5330, Fax: 82-31-780-5333 E-mail: eye@cha.ac.kr

Received 24 May 2018 Revised 15 June 2018 Accepted 26 August 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the clinical characteristics of xanthelasma palpebrarum as well as surgical results of upper blepharoplasty with a local flap technique.

Methods

We conducted a retrospective cross-sectional study including 12 patients who underwent removal of xanthelasma palpebrarum and upper blepharoplasty with the local flap technique from January 2010 to December 2017.

Results

A total of 18 eyelids of 12 patients were included in this study. The average age was 47.0 years and three patients (25.0%) were male and the other nine patients (75.0%) were female. There were seven patients (58.3%) on both sides of xanthelasma palpebrarum, and five patients (41.7%) on one side. There was hyperlipidemia in four patients (33.3%), hyper-triglyceridemia in two patients (18.2%), and hyper-low density lipoproteinemia in two patients (18.2%). Two patients had recurrence and the same surgery was performed. There was no postoperative complication. All patients were satisfied except for asymmetry in the postoperative end, and overall postoperative satisfaction was 83.3% (10/12 patients).

Conclusions

Xanthelasma palpebrarum often develops in both upper eyelids in middle-aged or older patients. Upper blepharoplasty with a local flap technique for the treatment of xanthelasma palpebrarum is an effective treatment for patients, especially in cases of ptosis or blepharochalasis. However, it should be noted that asymmetry of eyelids may occur after the surgery when surgery is performed on only one side.

Keywords: Local flap technique, Upper blepharoplasty, Xanthelasma, Xanthelasma palpebrarum

References

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Figure 1.

Intraoperative photographs of upper blepharoplasty with local flap technique. (A) Incision of local flap. (B) Flap rotation. (C) Adjustment of flap to cover the defect. (D) Apposition of flap margin. (E) Sutured flap. (F) Upper blepharoplasty.

Figure 2.

Photographs of patients. (A) Preoperative photograph of 67-year old woman. (B) Postoperative photograph of 67-year old woman. (C) Preoperative photograph of 47-year old man. (D) Postoperative photograph of 47-year old man.

Figure 3.

Algorithm for management of patient with xanthelasma palpebrarum. The underlying medical condition, size and location of the lesion should be considered in treatment of xanthelasma palpebrarum. LDL = low density lipoprotein; IHD = ischemic heart disease; TCA = trichloroacetic acid.

Table 1.

Summary of characteristics of patients

Factor	Value
Age (years)	47.0 ± 11.1
Sex
Male	3 (25.0)
Female	9 (75.0)
Location
Unilateral	7 (58.3)
Bilateral	5 (41.7)
Lipid profile
TG	2 (16.7)
LDL	2 (16.7)
Recurrence	2 (16.7)

Values are presented as mean ± SD or n (%).

TG = triglyceride; LDL = low density lipoprotein.

Table 2.

Demographic characteristics of patients

Patient	Age (years)	Sex	Location	Size (mm²)	Thickness (mm)	Underlying disease	Lipid profile	Result	Follow up duration (months)	Recurrence
1	49	F	UL:OD	12 × 3 (28.7)	3	–	LDL	Good	7	+
							(252 mg/dL)
2	65	F	UL:OU	6 × 3 (14.1),	1, 1	HTN		Good	3	+
				5 × 3 (11.8)
3	56	F	UL:OU	10 × 3 (23.6),	1, 1	–		Good	1.5	–
				10 × 2 (15.7)
4	41	F	UL:OS	6 × 5 (23.6)	1	–		Unsatisfaction	4	–
5	62	F	UL:OD	11 × 7 (60.4)	2	–		Good	2	–
6	57	F	UL:OU	6 × 4 (18.8),	2, 2	–	TG	Good	1.5	–
				6 × 3 (14.1)			(377 mg/dL)
7	67	F	ULLL:OU	8 × 6 (37.7),1	1, 1, 1, 1	HTN	TG	Good	1	–
				5 × 3 (11.8)		Dyslipidemia	(276 mg/dL)
				2 × 1 (1.6),
				2 × 2 (3.1)
8	32	M	UL:OS	12 × 2 (18.8)	1	–		Good	1	–
9	47	M	UL:OD	12 × 8 (75.4)	2	–		Good	1.5	–
10	38	F	UL:OS	7 × 2 (10.1)	1	–	LDL	Unsatisfaction	1	–
							(224 mg/dL)
11	42	M	UL:OU	22 × 4 (69.1),	4, 4	–		Good	1	–
				12 × 8 (76.9)
12	45	F	UL:OU	9 × 8 (56.5),	4, 4	–		Good	1	–
				10 × 5 (39.3)
Mean	47 ±			30.6 ± 24.3	1.9 ± 1.2				2.1 ± 1.8
	11.1

Values are presented as mean ± SD unless otherwise indicated.

F= female; UL = upper lid; OD = oculus dexter; LDL = low density lipoprotein; OU = oculus uterque; HTN = hypertension; OS = oculus sinister; TG = triglyceride; ULLL = upper lid and lower lid; M = male; + = positive (recurrence); – = negative (no recurrence).

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