Epidemiology of Surgically Managed Eyelid Injuries and Associated Factors with Complications: A Retrospective Cohort Study

PURPOSE: Eyelid trauma often necessitates surgical intervention, yet remains understudied, with postoperative complications poorly described. This study aims to identify factors associated with complications following surgical treatment of traumatic eyelid injuries. METHODS: A retrospective non-concurrent cohort study was conducted to analyze complications in patients undergoing surgical repair of eyelid injuries at two ophthalmology centers in Cali, Colombia, from January 2017 to December 2021. Factors associated with postoperative complications were identified using multivariable logistic regression clustered by care site. RESULTS: A total of 365 patients underwent surgical intervention for eyelid traumas; with a mean age of 31±18 years. Most cases were covered by public insurance (58.1%) or employer-sponsored insurance (12.1%). Unintentional injuries comprised 60.6%; while intentional injuries accounted for 37%, primarily due to interpersonal violence (36.7%). The postoperative complication rate was 11%, including impaired healing (3.29%), tearing (3.29%), surgical site infection (2.74%), stent extrusion (1.10%), lagophthalmos (0.55%), and eyelid malposition (0.82%). Multivariable analysis showed that female sex (Odds ratio [OR]=3.00, 95% Confidence Interval [95%CI]=2.93-3.06), presence of fractures (OR=2.01, 95%CI=1.5-2.7), anterior segment damage (OR=2.29, 95%CI=1.83-2.86), and greater tissue loss (25-49%: OR=2.55, 95%CI=2.17-2.99; ≥50%: OR=1.41, 95%CI=1.09-1.81) were associated withhigher odds of postoperative complications. CONCLUSION: Postoperative complication were associated with palpebral tissue loss, involvement of both upper and lower eyelid, orbital fractures, and anterior segment injuries. Future studies should use prospective designs with standardize follow-up after reconstruction.