PURPOSE To review the literature on the efficacy and safety of bioengineered acellular dermal matrix (BADM) grafts for lower eyelid retraction repair. METHODS A literature search was conducted in the PubMed database initially in January 2018 and updated in July 2019 to identify all studies in the English language literature on the use of BADM grafts in eyelid reconstruction. The searches yielded 193 citations, and 15 of the 34 articles selected for full review met all inclusion criteria for this assessment. A panel methodologist then assigned a level of evidence rating for each study. Two of the 15 studies included were rated level II and 13 were rated level III. RESULTS The definition of success varied, but lower eyelid position improvement using lower lid margin-to-pupillary reflex distance was the most common outcome measure. Other end points were the amount of lagophthalmos, cosmesis, exposure, reoperation, or complications, as well as prosthesis retention in anophthalmic socket cases. The surgeon-reported success rate of these outcomes ranged from 75% to 100%. Minor complications included cyst formation, infection, chemosis, pyogenic granuloma, and corneal abrasion. No serious complications such as blindness, anaphylactic reaction, or terminal disease transmission occurred. Of the 526 implants included for assessment in these disparate studies, 27 cases (5%) required reoperation. CONCLUSIONS No level I evidence was available, and the existing level II and level III studies have variable primary end points, study design limitations, and only short-term follow-up data. The current literature suggests that BADM grafts represent an implantation option for lower eyelid retraction repair. Short-term results are favorable, and the materials used may fill an important gap in care for patients for whom no acceptable alternatives exist, but long-term safety and efficacy remain unknown.

中文翻译：

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生物工程化的脱细胞真皮基质间隔物移植物用于下眼睑回缩修复：美国眼科学会的一份报告。

目的回顾有关生物工程脱细胞真皮基质（BADM）移植物用于下睑退缩修复的功效和安全性的文献。方法最初于2018年1月在PubMed数据库中进行文献检索，并于2019年7月进行了更新，以鉴定英语文献中有关在眼睑重建中使用BADM移植物的所有研究。检索获得193次引用，在选择进行全面审核的34篇文章中，有15篇符合该评估的所有纳入标准。然后，小组方法学家为每项研究指定了证据等级。纳入的15项研究中有2项被评为II级，13项被评为III级。结果成功的定义各不相同，但是使用下睑缘至瞳孔反射距离降低下睑位置是最常见的结局指标。其他终点是眼睑积水，整容，暴露，再次手术或并发症的数量，以及在非眼科眼窝病例中的假体保留。外科医生报告的这些结果的成功率范围为75％至100％。次要并发症包括囊肿形成，感染，化学反应，化脓性肉芽肿和角膜擦伤。没有发生严重的并发症，例如失明，过敏反应或疾病的最终传播。在这些不同的研究中纳入评估的526种植入物中，有27例（5％）需要再次手术。结论尚无I级证据，现有的II级和III级研究具有主要终点指标，研究设计局限性以及仅有短期随访数据。目前的文献表明，BADM移植物代表了下睑回缩修复的植入选择。短期结果是有利的，所用的材料可能会填补没有可接受的替代品的患者护理的重要空白，但长期安全性和有效性仍未知。