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Related Experiment Video

Updated: Oct 12, 2025

Three-Dimensional Reconstruction of Orbital Fractures
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Upper Eyelid Contour Changes After Orbital Decompression in Graves Orbitopathy.

Antonio A V Cruz1, Bruna Equitério1, Stefania B Diniz2

  • 1From the School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.

Ophthalmic Plastic and Reconstructive Surgery
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Summary

Orbital decompression surgery improves upper eyelid contour, reducing lateral flare in many patients. In 40% of cases, proptosis reduction alone normalizes eyelid shape, potentially decreasing the need for further eyelid retraction surgery.

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Area of Science:

  • Ophthalmology
  • Plastic Surgery
  • Orbital Surgery

Background:

  • Upper eyelid contour abnormalities, such as lateral flare, can occur after orbital decompression.
  • Assessing changes in eyelid contour is crucial for surgical outcomes.

Purpose of the Study:

  • To evaluate the effect of orbital decompression on the upper eyelid contour.
  • To determine if orbital decompression alone can correct lateral eyelid flare.

Main Methods:

  • A paired cross-sectional analysis of 103 eyes from 66 patients undergoing orbital decompression.
  • Measurement of upper eyelid contour using Bézier lines and midpupil eyelid margin (MPD) distances.
  • Classification of 'flare' based on lateral MPD height relative to margin reflex distance (MRD 1).

Main Results:

  • Preoperatively, 63% of contours showed lateral flare.
  • Post-decompression, MRD1 decreased by 0.4 mm, and contour shifted 0.8 mm medially.
  • Orbital decompression reduced lateral curvature, resolving the flare sign in 40% of affected eyelids.

Conclusions:

  • Orbital decompression significantly impacts lateral eyelid contour.
  • The procedure can diminish the need for additional eyelid retraction surgery.
  • Proptosis reduction alone normalizes eyelid contour in 40% of patients.