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Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Digital Analysis of Eyelid Features and Eyebrow Position Following CO2 Laser-assisted Blepharoptosis Surgery
Xiaodong Zheng1, Hirohiko Kakizaki1, Tomoko Goto1
1Department of Ophthalmology, Ehime University School of Medicine, Toon City, Ehime, Japan; Hanamizuki Eye Clinic, Matsuyama, Ehime, Japan; and Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan.
Background:
To compare the margin reflex distance of the upper (MRD-1) and lower (MRD-2) eyelids and the eyebrow height (EBH) in patients with involutional and hard contact lens wear--induced blepharoptosis before and after ptosis surgery.
Methods:
Sixty patients with acquired blepharoptosis were studied. Group 1 consisted of 30 patients with involutional ptosis (age, 75.8 ± 6.4 years), and group 2 consisted of 30 patients with hard contact lens wear-induced ptosis (age, 50.2 ± 7.1 years). All patients underwent bilateral, CO2 laser-assisted levator aponeurosis advancement surgery. A digital image was taken in the primary position before and 2 months after the surgery. The image was analyzed by the ImageJ (NIH, Bethesda, Md.) software. Parameters included MRD-1, MRD-2, EBH, and ocular surface area (OSA).
Results:
After surgery, all patients had a significant increase in the MRD-1 and OSA and a decrease in the EBH (all P < 0.001). The increase in MRD-1 was significantly larger in group 1 than in group 2 (P = 0.028). The decrease of EBH was significantly greater in group 1 than in group 2 (P = 0.007). Group 1 had a slight decrease in the MRD-2, but group 2 had a significant increase after surgery (P = 0.026). The change in the OSA was not significantly different between the 2 groups.
Conclusions:
Digital image analyses can be used for precise measurements of the eyelid features. The disparity in the changes of eyelid and eyebrow features between the 2 groups may suggest different responses of the external eyelid muscles to surgery between cases of different etiology.
