Humans ; Lacrimal Apparatus ; Endoscopy ; Carcinoma ; Eyelids

OBJECTIVE: To investigate effectiveness of transconjunctival lower eyelid blepharoplasty with "super released" orbital fat in correction of lower eyelid pouch protrusion and tear trough and palpebromalar groove depression. METHODS: A clinical data of 82 patients (164 sides) with lower eyelid pouch protrusion and tear trough and palpebromalar groove depression, who met the selection criteria between September 2021 and May 2022, was retrospectively analyzed. Of the included patients, 3 were males and 79 were females, with an average age of 34.5 years (range, 22-46 years). All patients had varying degrees of eyelid pouch protrusion and tear trough and palpebromalar groove depression. The deformities were graded by the Barton grading system as gradeⅠ in 64 sides, grade Ⅱ in 72 sides, and grade Ⅲ in 28 sides. The orbital fat transpositions were performed through the lower eyelid conjunctival approach. The membrane surrounding the orbital fat was completely released, allowing the orbital fat to fully herniate until the herniated orbital fat did not retract significantly in a resting and relaxed state, which is regarded as the "super released" standard. The released fat strip was spread into the anterior zygomatic space and the anterior maxillary space, and percutaneous fixed to the middle face. The suture that penetrates the skin was externally fixed by adhesive tape pasting without knotted. RESULTS: There were 3 sides with chemosis after operation, 1 side with facial skin numbness, 1 side with mild lower eyelid retraction at the early stage after operation, and 5 sides with slight pouch residue. No hematoma, infection, or diplopia occurred. All patients were followed up 4-8 months, with an average of 6.2 months. The eyelid pouch protrusion, tear trough, and palpebromalar groove depression were significantly corrected. At last follow-up, the deformity was graded by Barton grading system as grade 0 in 158 sides and grade Ⅰ in 6 sides, with a significant difference compared to the preoperative score ( P<0.001). Patient's self-evaluation satisfaction reached very satisfied in 67 cases (81.7%), satisfied in 10 cases (12.2%), generally satisfied in 4 cases (4.8%), and dissatisfied in 1 case (1.2%). CONCLUSION The "super released" orbital fat can effectively prevent the retraction of orbital fat, reduce the probability of residual or recurrence of eyelid pouches, and improve the correction effect.
Male ; Female ; Humans ; Adult ; Blepharoplasty ; Retrospective Studies ; Depression ; Eyelids/surgery* ; Face/surgery* ; Adipose Tissue/transplantation*

OBJECTIVE: To summarize the etiology mechanism and treatment of iatrogenic blepharoptosis after double eyelid surgery in Asia. METHODS: To extensively review the literature related to iatrogenic blepharoptosis after double eyelid surgery, and to summarize and analyze the related anatomical mechanism, existing treatment options, and indications. RESULTS: Iatrogenic blepharoptosis is a relatively common complication after double eyelid surgery, sometimes it is combined with other eyelid deformities such as sunken upper eyelid and wide double eyelid, which makes it difficult to repair. The etiology is mainly caused by improper adhesion of tissues and scars, improper removal of upper eyelid tissue, and injury of a link of levator muscle power system. Whether blepharoptosis occurs after double eyelid surgery by incision or suture, it should be repaired by incision. The principles of repair include surgical loosening of tissue adhesion, anatomical reduction, and repair of damaged tissues. The key is to use surrounding tissues or transplanted fat to prevent adhesion. CONCLUSION When repairing iatrogenic blepharoptosis clinically, appropriate surgical methods should be selected based on the causes and severity of the blepharoptosis, combined with treatment principles, in order to achieve better repair results.
Humans ; Blepharoptosis/surgery* ; Treatment Outcome ; Retrospective Studies ; Blepharoplasty/methods* ; Eyelids/surgery* ; Iatrogenic Disease ; Oculomotor Muscles/surgery*

Objectives: To determine the normative values for upper eyelid and eyebrow dimensions among adult Filipinos and the effects of age and sex on these parameters. Methods: This was a prospective, descriptive study involving 75 Filipino adults who were recruited from a single tertiary government hospital in the Philippines. Profile data collected included age and sex, while clinical data included measurements of the pretarsal skin height (PSH), eyelid crease height (ECH) and eyebrow height (EBH) by a single observer, with the average of an individual’s eyes used as the representative measurement. An intereye correlation coefficient was calculated. The subjects were categorized into 4 age groups (i.e. early, early middle, late middle, and late adulthood) and according to gender for statistical analyses. All measurements were compared across age groups using Analysis of Variance (ANOVA) and between sexes using t-test. Results: This study included 43 males and 32 females. Overall, mean PSH measured was 4.5 ± 1.5 mm; mean ECH was 5.9 ± 1.7 mm, while mean EBH was 10.4 ± 2.7 mm. Means of PSH and EBH showed similar measurements between sexes. The mean ECH of females in early adulthood was significantly higher than the mean ECH of males belonging to the same age group (p=0.01). Among the female group, mean EBH was also observed to increase with age (p=0.02). A high degree of inter-eye correlation was observed (r = 0.94 to 1.00). Conclusion Filipinos have unique upper eyelid and brow features compared to other races. Sex-related differences were not identified in PSH and EBH. While EBH increased with age among female subjects.
Eyelids

PURPOSE: To determine whether eyeliner tattoo affects the meibomian gland (MG) and ocular surface.METHODS: The medical charts of an eyeliner tattoo group (16 eyes of 8 patients) and a control group (16 eyes of 18 patients) were retrospectively reviewed. The ocular surface disease index questionnaire, ocular surface staining score, tear film break-up time (TBUT), upper eyelid abnormality, meibum expressibility and quality, and MG loss and tear film lipid layer thickness (LLT) which measured with LipiView® (TearScience, Morrisville, NC, USA) were compared. In the tattoo group, the correlation between the distance from the MG orifice to the tattoo pigment and other indices were analyzed.RESULTS: Compared to controls, the tattoo group had a significantly higher ocular surface disease index (p = 0.002), shorter TBUT (p < 0.001), higher vessel engorgement of the upper lid (p = 0.016), poorer meibum expressibility and quality (p = 0.006 and p < 0.001, respectively), higher MG loss (p < 0.001), and thinner LLT (p = 0.024). In the tattoo group, the closer the tattoo was to the MG orifice, the more the upper lid vessel was engorged and the more MG loss occurred (r(s) = −0.560, p = 0.024; r(s) = −0.563, p = 0.023, respectively), and a thinner LLT was observed (r(s) = 0.567, p = 0.022).CONCLUSIONS: Eyeliner tattoos may be related to changes in the lid margin, loss of the MG, and thinning of the LLT.
Dry Eye Syndromes ; Eyelids ; Meibomian Glands ; Retrospective Studies ; Tears

No abstract available.
Eyelids

Periorbital dermatochalasis with upper eyelid hooding, brow ptosis, and sunken eyelids may appear with age. Because classic blepharoplasty is unable to correct all these issues, we developed a single operation, which we present herein, to correct dermatochalasis accompanied by sunken eyelids. This sub-brow approach is used with simultaneous browpexy by fixing the orbital portion of the orbicularis oculi muscle (OOM) to the periosteum immediately above the supraorbital rim using sutures with 3 or 4 points of fixation and correcting sunken eyelids by burying the elevated dermis, fat, and OOM after de-epithelization in the lower flap of the sunken upper eyelid along the submuscular plane. This method enables the correction of sunken eyelids during the same operation without requiring an additional procedure, and offers the advantages of a shortened operation time and decreased cost. The presence of sunken eyelids in patients with dermatochalasis and severe lateral hooding may be corrected by the procedure described herein, thereby achieving periorbital rejuvenation while maintaining the original shape of the eyes.
Blepharoplasty ; Dermis ; Eyelids ; Humans ; Methods ; Middle Aged ; Orbit ; Periosteum ; Rejuvenation ; Skin Aging ; Sutures

BACKGROUND: Blepharoptosis is the drooping of the margin of the upper eyelid, which narrows the palpebral fissure and makes it difficult to open the eye. Various surgical methods are used to correct blepharoptosis and have been investigated in different studies. After surgery, blepharoptosis can relapse over time, which affects a patient’s satisfaction with the operation. However, few studies have investigated the long-term outcomes of patients after blepharoptosis surgery. METHODS: From 1991 to 2013, 325 patients (480 eyelids) underwent frontalis muscle transfer or Müller-aponeurosis composite flap advancement in our clinic. We analyzed 12 patients (13 eyelids) with severe ptosis who had been followed-up for more than 5 years. Six patients underwent frontalis muscle transfer for the correction of seven eyelids, while Müller-aponeurosis composite flap advancement was performed on six patients (six eyelids). The marginal reflex distance (MRD1), area of corneal exposure (ACE), and height of the eyebrow were used to analyze the objective outcomes, and the Glasgow Benefit Inventory questionnaire was used for the analysis of subjective patient satisfaction. RESULTS: There were no significant differences in the MRD1, ACE, and eyebrow height between the two methods used to correct ptosis. However, over the long-term (>5 years), the MRD1, ACE, and eyebrow height were better maintained in patients who underwent Müller-aponeurosis composite flap advancement than in patients who received frontalis muscle transfer. CONCLUSIONS: Both surgeries were effective for blepharoptosis correction. However, Müller-aponeurosis composite flap advancement was better for long-term maintenance after surgery than frontalis muscle transfer.
Blepharoplasty ; Blepharoptosis ; Eyebrows ; Eyelids ; Humans ; Patient Satisfaction ; Recurrence ; Reflex

Mucosa-associated lymphoid tissue (MALT) lymphoma is an uncommon form of non-Hodgkin lymphoma involving the mucosa-associated lymphoid tissue. Most commonly affected organ is the stomach. But, it could affect almost every organ in the whole body. If they have suspicious lesion, excision biopsy could be made. For staging, blood test including blood smear, abdomen and chest tomography or scan will be checked. Also, bone marrow test can be done if it is needed. The patient had visited the clinic for palpable mass on right lower eyelid. With excisional biopsy, it was diagnosed as lymphoid hyperplasia on pathologic test. But 2 years later, the patient came with recurrent symptom for our department with worry. At that time, we recommended excisional soft tissue biopsy under general anesthesia. Unfortunately, it was revealed MALT lymphoma on pathologic finding. It turned out to be stage 3 in Ann Arbor staging system without B symptoms. Hematologic consultation was made and she was treated with adjuvant chemotherapy for eight cycles to complete remission. We report a case of MALT lymphoma on subcutaneous tissue at right lower eyelid previously diagnosed as lymphoid hyperplasia.
Abdomen ; Anesthesia, General ; Biopsy ; Bone Marrow ; Chemotherapy, Adjuvant ; Eyelids ; Hematologic Tests ; Humans ; Hyperplasia ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Non-Hodgkin ; Stomach ; Subcutaneous Tissue ; Thorax

No abstract available.
Conjunctiva ; Soft Tissue Neoplasms ; Tarsal Bones ; Eyelids