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Maria M Choudhary, Rao Chundury, Tal Rubinstein, Julian Perry; Effect of External Levator Resection for Blepharoptosis Repair on Eyelid Contour. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4743.
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Eyelid contour is important for eyelid symmetry and represents an important clinical outcome after blepharoptosis repair. We sought to quantitatively determine the effect of external levator resection for blepharoptosis repair on upper eyelid contour.
After obtaining Institutional Review Board (IRB) approval we retrospectively reviewed charts of consecutive patients undergoing unilateral external levator resection (ELR) for blepharoptosis repair at the Cole Eye Institute between June 2012 and October 2013. Exclusion criteria included concurrent or prior eyelid or eyebrow surgery, lack of appropriate photographs, and a known history of systemic disease affecting the eyelid.<br /> <br /> Preoperative and postoperative digital images of the palpebral fissure in primary gaze of patients were analyzed. Radial mid-pupil to eyelid margin distances were calculated in pixels by digitally rendering vertical lines 15 degrees apart (00, 150, 30°, 45°, 60°, 75°, 90°, 105°, 120°, 135°, 150° and 1800) using NIH ImageJ64 software (Bethesda, MD). Eyelid contour was computed and evaluated as the ratios of equidistant angles from the midline similar to a previously published study (for example: 105°/75°). A ratio of 1 represents favorable contour. Student’s t-tests were used to compare the pre-operative and post-operative contour ratios to the fellow non-operative eye.
Eight patients met inclusion criteria. Central eyelid elevated by a mean of 285.92% post-ELR. The mean lateral/medial ratios at each angle pre and post-ELR and in the fellow non-operative eye are listed in Table 1. The four central post-ELR lateral/medial ratios were significantly more symmetric than the fellow non-operative eye as shown in Table 2.
Eyelid contour changes significantly following external levator resection for blepharoptosis. In this study, pre and post-ELR equidistance angle ratios were analyzed and compared to a fellow non-operative eye. The ELR procedure was found to result in a significantly improved eyelid contour when compared to the fellow non-operative eye.
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