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Related Experiment Video

Updated: Jun 22, 2025

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Determining Asymmetry Thresholds in Anophthalmia/Microphthalmia Using a Three-dimensional Animated Model.

Emiel J Romein1, Annabel L W Groot1, Jelmer S Remmers1

  • 1Department of Ophthalmology, Amsterdam UMC, University of Amsterdam, Amsterdam Orbital Center, Amsterdam, Netherlands.

Ophthalmic Plastic and Reconstructive Surgery
|June 27, 2024
PubMed
Summary

Facial asymmetry due to congenital microphthalmia or anophthalmia is unacceptable if the sunken eye is 6mm or more, the eyelid width is less than 79%, or the eye is displaced by 2mm or more.

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Area of Science:

  • Ophthalmology
  • Plastic Surgery
  • Craniofacial Surgery

Background:

  • Congenital microphthalmia and anophthalmia cause facial asymmetry.
  • Current guidelines for acceptable asymmetry are lacking.

Purpose of the Study:

  • To establish objective thresholds for facial asymmetry in children with microphthalmia/anophthalmia.
  • To determine when surgical correction is perceived as necessary.

Main Methods:

  • 3D facial scanning and modeling of asymmetries.
  • Creation of videos demonstrating varying degrees of enophthalmos, palpebral fissure asymmetry, and eye displacement.
  • Questionnaire assessing acceptability of facial features on a 0-10 scale.

Main Results:

  • Significant correlation between asymmetry degree and acceptability scores.
  • Thresholds for unacceptable asymmetry: enophthalmos ≥6mm, palpebral fissure width ≤79%, eye displacement ≥2mm.
  • Adjusting vertical palpebral fissure height to width worsened acceptability.

Conclusions:

  • Objective criteria for unacceptable facial asymmetry were identified.
  • These findings aid in evaluating treatment outcomes for congenital microphthalmia and anophthalmia.