The present study investigated the outcomes of nonsurgical treatment of abnormal eyelid position using hyaluronic acid gel.

Abnormal eyelid position including 18 eyes with lid retraction, 10 eyes with lagophthalmos, and 18 eyes with ectropion were treated with hyaluronic acid gel. The mean age was 50 ± 17.8 years and the mean observation period was 11 ± 2.4 months. The photographs of patients were taken before injection, 1 month, 4 months, and at the last follow-up after injection. The marginal reflex distance 1 (MRD₁) and marginal reflex distance 2 (MRD₂) of patients were measured and analyzed by the Image J Program. The severity of ectropion was graded by a scoring system.

Ten eyes with lagopthalmos improved 1.9 ± 1.2 mm after injection. The 16 eyes with lid retraction improved 1.3 ± 0.9 mm. Twenty-three eyes with ectropion improved and 17 eyes (81%) were completely corrected. The average frequency of injection was 1.1 and the average dose of injection was 0.4 ± 0.12 cc. No significant complications were observed in any patient.

Hyaluronic acid gel injections can be used safely and effectively as a nonsurgical treatment for patients with abnormal eyelid position without any significant complications.