A preliminary study on a grading scale for objectively assessing the degree of laxity of upper eyelid skin
10.3760/cma.j.cn114453-20240716-00186
- VernacularTitle:一种客观评价上睑皮肤松弛程度的分级量表初探
- Author:
Kun MA
1
;
Tuanjie HOU
1
;
Pingsong LI
1
;
Xiao CHEN
1
;
Le MA
1
Author Information
1. 扬州大学附属苏北人民医院整形烧伤科-医学美容科，扬州 225001
- Publication Type:Journal Article
- Keywords:
Eyelids;
Cutis laxa;
Blepharoptosis;
Periorbital rejuvenation;
Digital photography;
Effect evaluation;
Evaluation method
- From:
Chinese Journal of Plastic Surgery
2025;41(1):26-31
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the feasibility of a new clinical grading scale for assessing the degree of laxity of upper eyelid skin.Methods:From May 2022 to October 2023, the patients who underwent upper eyelid skin laxity plastic surgery in the Department of Plastic Surgery and Burns-Department of Medical Cosmetology, Northern Jiangsu People’s Hospital Affiliated to Yangzhou University, were prospectively enrolled. The degree of upper eyelid skin laxity was graded independently by three plastic surgeons who did not participate in the operation according to the grading scale and using facial photographs of the patients.The clinical grading scale categorizes the degree of skin laxity into 4 grades ranging from 0 to 3 degrees, by analyzing the position of the lower edge of the upper eyelid skin relative to the upper eyelid edge and the pupil, and the higher the grade, the more serious the degree of skin relaxation. If bilateral upper eyelid skin laxity were presented, the grade of the side with more severe laxity was taken as the grade of the upper eyelid skin laxity of the patient. The Kendall coefficient (range -1-1) of the three doctors’ grading result before and after operation was calculated respectively. The closer the value was to 1, the better the consistency of the three doctors, and the better the stability of the grading scale. The degree of upper eyelid skin laxity before and after operation was expressed as M ( Q1, Q3), and the paired Wilcoxon signed rank test was used for comparison. Results:A total of 50 female patients aged 32 to 67 years old (mean 45.3 years) who underwent bilateral upper eyelid skin laxity plastic surgery were enrolled. The Kendall coefficients of the grading result of the upper eyelid skin laxity of 50 patients by three doctors before and after operation were 0.975 and 0.882, respectively ( P<0.01). It suggested high consistency among evaluators for the same patient. 50 patients were graded as 2(1, 2) degree and 0(0, 0) degree preoperatively and postoperatively, respectively, indicating that the degree of upper eyelid skin laxity was significantly improved postoperatively. The result of Wilcoxon signed rank test showed that there were significant differences in preoperative and postoperative grading result of the three doctors ( P<0.01). Conclusion:The grading scale of upper eyelid skin laxity is objective and easy to use. Its evaluation result are stable and repeatable, and it can effectively analyze the changes of the degree of upper eyelid skin relaxation before and after surgery.
