Pre-and postoperative quantitative analysis of contour abnormalities in graves upper eyelid retraction

Sara F T Ribeiro, Gherusa H. Milbratz, Denny M. Garcia, Martin Devoto, Guilherme H. Neto, Ricardo Mörschbächer, Filipe J. Pereira, Antonio A V Cruz

Research output: Contribution to journalArticle

Abstract

PURPOSE:: One of the most common problems of the surgical management of Graves upper eyelid retraction is the occurrence of eyelid contour abnormalities. In the present study, the postoperative contour of a large sample of eyelids of patients with Graves orbitopathy was measured. Methods:: The postoperative upper eyelid contour of 62 eyes of 43 patients with Graves orbitopathy was subjectively classified by 3 experienced surgeons in 3 categories: poor, fair, and good. The shape of the eyelid contours in each category was then measured with a recently developed custom-made software by measuring multiple midpupil eyelid distances each 15° along the palpebral fissure. The upper eyelid contour of 60 normal subjects was also quantified as a control group. Results:: The mean ratio between the sum of the lateral and medial midpupil eyelid distances (lateral/medial ratio) was 1.10 ± 0.11 standard deviation in controls and 1.15 ± 0.13 standard deviation in patients. Postoperatively, the mean midpupil eyelid distance at 90 was 4.16 ± 1.13 mm standard deviation. The distribution lateral/medial ratios of the eyelids judged as having good contours was similar to the distribution of the controls with a modal value centered on the interval between 1.0 and 1.10. The distribution of lateral/medial ratios of the eyelids judged as having poor contour was bimodal, with eyelids with low and high lateral/medial ratios. Low lateral/medial ratios occurred when there was a lateral overcorrection, giving the eyelid a flat or a medial ptosis appearance. High lateral/medial ratios were due to a central or medial overcorrection or a lateral peak maintenance. Conclusions:: Postoperative upper eyelid contour abnormalities can be quantified by comparing the sum of multiple midpupil eyelid distances of the lateral and medial sectors of the eyelid. Low and high lateral/medial ratios are anomalous and judged as unpleasant.

Original languageEnglish (US)
Pages (from-to)429-433
Number of pages5
JournalOphthalmic Plastic and Reconstructive Surgery
Volume28
Issue number6
DOIs
Publication statusPublished - Nov 2012
Externally publishedYes

    Fingerprint

ASJC Scopus subject areas

  • Ophthalmology
  • Surgery

Cite this

Ribeiro, S. F. T., Milbratz, G. H., Garcia, D. M., Devoto, M., Neto, G. H., Mörschbächer, R., ... Cruz, A. A. V. (2012). Pre-and postoperative quantitative analysis of contour abnormalities in graves upper eyelid retraction. Ophthalmic Plastic and Reconstructive Surgery, 28(6), 429-433. https://doi.org/10.1097/IOP.0b013e3182696532