[Two surgical methods to modify upper eyelid retraction with thyroid associated-ophthalmopathy]

Area of Science:

• Ophthalmology
• Surgical Techniques
• Endocrinology

Background:

• Thyroid-associated ophthalmopathy (TAO) frequently causes upper eyelid retraction.
• Surgical intervention is often necessary to correct this debilitating condition.

Purpose of the Study:

• To compare the efficacy and safety of two surgical methods for upper eyelid retraction in TAO.
• To evaluate the recurrence rates associated with each surgical approach.

Main Methods:

• A randomized controlled trial involving 22 patients (32 eyes) with inactive TAO.
• Group A underwent central tenotomy of the levator aponeurosis (11 patients, 18 eyes).
• Group B underwent lengthening of Müller's muscle combined with levator muscle (11 patients, 14 eyes).
• A 6-month follow-up period was employed to assess treatment outcomes.

Main Results:

• Both surgical techniques demonstrated significant improvement in upper eyelid retraction (P < 0.01).
• No statistically significant difference in overall efficacy was observed between the two methods (P > 0.05).
• Recurrent retraction occurred in 4 patients (6 eyes) in Group A versus 1 patient (1 eye) in Group B (P < 0.05).
• No cases of overcorrection were reported in either group.

Conclusions:

• Central tenotomy and lengthening of Müller's muscle with levator muscle are both safe and effective for correcting upper eyelid retraction in TAO.
• Lengthening Müller's muscle combined with levator muscle appears to have a lower rate of recurrent retraction compared to central tenotomy.