The Importance of Lower Eyelid Position in Aging Blepharoplasty

Joohyun Kim; Sungwon Yang; Jinhwan Park; Hwa Lee; Sehyun Baek

doi:10.3341/jkos.2019.60.4.303

Journal List > J Korean Ophthalmol Soc > v.60(4) > 1120579

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Kim, Yang, Park, Lee, and Baek: The Importance of Lower Eyelid Position in Aging Blepharoplasty

Original Article

Journal of the Korean Ophthalmological Society 2019; 60(4): 303-307.

Published online: 17 April 2019

DOI: https://doi.org/10.3341/jkos.2019.60.4.303

The Importance of Lower Eyelid Position in Aging Blepharoplasty

Joohyun Kim, MD, Sungwon Yang, MD, Jinhwan Park, MD, PhD, Hwa Lee, MD, PhD, Sehyun Baek, MD, PhD

Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea.

Address reprint requests to Sehyun Baek, MD, PhD. Department of Ophthalmology, Korea University Guro Hospital, #148 Gurodong-ro, Guro-gu, Seoul 08308, Korea. Tel: 82-2-2626-1260, Fax: 82-2-857-8580, shbaek6534@korea.ac.kr

Received 15 November 2018 Revised 31 December 2018 Accepted 23 March 2019

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the changes in upper and lower eyelid positions after upper blepharoplasty in elderly patients.

Methods

Patients diagnosed with dermatochalasis and treated with upper blepharoplasty were included in the study. Clinical photographs taken preoperatively and immediately after surgery were retrospectively reviewed. Marginal reflex distance (MRD) 1, MRD2 and palpebral fissure height (PFH) were measured from the photographs using Image J software.

Results

A total of 184 patients (72 males and 112 females) were included in the study. The preoperative mean MRD1, MRD2, and PFH were 1.97 ± 1.27 mm, 4.74 ± 0.97 mm, and 6.70 ± 1.69 mm, respectively. The postoperative mean MRD1, MRD2, and PFH were 1.79 ± 0.79 mm, 4.16 ± 0.92 mm, and 5.95 ± 1.36 mm, respectively. Preoperative and postoperative MRD1 were not significantly different (p = 0.256), but the postoperative MRD2 and PFH significantly decreased compared to preoperative values (both, p < 0.001).

Conclusions

When performing upper blepharoplasty in elderly patients, the surgeon should consider that the MRD2 and PFH could be decreased during surgery. When the surgeon estimates the correct amount of skin-muscle excision, the MRD1, but not PFH, should be considered.

Keywords: Blepharoplasty, Lower eyelid position, Marginal reflex distance 1, Marginal reflex distance 2, Palpebral fissure height

Figures and Tables

Figure 1

Marginal reflex distance 1 (MRD1), MRD2 and palpebral fissure height (PFH). MRD1 is the distance from the corneal light reflex to the level of the upper eyelid margin. MRD2 is the distance from the corneal light reflex to the level of the lower eyelid margin. PFH is the distance from the level of the upper eyelid margin to the level of the lower eyelid margin.

Figure 2

A case of 61-year old male patient. (A) Preoperative photograph. Marginal reflex distance 1 (MRD1), MRD2, and palpebral fissure height (PFH) of right eye was 2.90 mm, 5.60 mm, and 8.50 mm, respectively. (B) Postoperative photograph. MRD1, MRD2, and PFH of right eye was 2.19 mm, 3.01 mm, and 5.20 mm, respectively. The arrows show that reverse ptosis was worsened immediately after surgery compared with preoperative status.

Table 1

Comparison of preoperative and postoperative eyelid position

Values are presented as mean ± standard deviation unless otherwise indicated.

MRD1 = marginal reflex distance 1; MRD2 = marginal reflex distance 2; PFH = palpebral fissure height.

^*Paired sample t-test.

Table 2

Comparison of preoperative and postoperative eyelid position in male patients group and female patients group

Values are presented as mean ± standard deviation unless otherwise indicated

MRD1 = marginal reflex distance 1; MRD2 = marginal reflex distance 2; PFH = palpebral fissure height

^*Paired sample t-test.

Notes

This study was supported in part by Alumni of Department of Ophthalmology, Korea University College of Medicine in 2013.

^{Conflicts of Interest} The authors have no conflicts to disclose.

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