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Impact of Canthal Height on Horizontal Upper Eyelid Peak Position: A Guide for Blepharoptosis Surgery.

Abstract
This study was aimed at examining the relationship between the horizontal upper eyelid peak position (Δpeak-pupil) and the difference between the medial and lateral canthal heights (Δcanthi) in Japanese individuals. Images of the left eyelid of 71 participants without eyelid disease were acquired with a camera with a slit-lamp microscope. Multivariate linear regression analysis was performed to determine the influence of age, sex, distance from the pupil center to the upper eyelid margin (margin reflex distance-1), Δcanthi, and palpebral fissure width on Δpeak-pupil. In addition, Δpeak-pupil distribution in participants with Δcanthi <3 (Group A), 3 to 6 (Group B), and >6 mm (Group C) was calculated as the average±2x the standard deviation. The mean Δpeak-pupil was 1.12 ± 1.29 mm (range: -1.44 to 6.12) and the mean Δcanthi was 4.50 ± 1.71 mm (1.02-7.96). Δcanthi was a significant determinant factor of Δpeak-pupil (P < 0.0001), whereas age (P = 0.62), sex (P = 0.88), margin reflex distance-1 (P = 0.29), and the horizontal palpebral fissure width (P = 0.65) were not related to Δpeak-pupil. The normal Δpeak-pupil ranges were -1.47 to 1.52, -0.95 to 3.22, and -0.84 to 4.73 mm in Groups A, B, and C, respectively. There was a statistically significant difference between the Group A and B ranges and between the Group A and C ranges (Kruskal-Wallis test, P < 0.01). It was concluded that the normal eyelid peak position differs according to medial-to-lateral canthal positional difference. This finding may help intraoperative determination of the upper eyelid peak position in blepharoptosis surgery.
AuthorsYoshiyuki Kitaguchi, Yasuhiro Takahashi, Hirohiko Kakizaki, Fumi Gomi, Kohji Nishida
JournalThe Journal of craniofacial surgery (J Craniofac Surg) 2020 Jan/Feb Vol. 31 Issue 1 Pg. 138-141 ISSN: 1536-3732 [Electronic] United States
PMID31764562 (Publication Type: Journal Article)
Topics
  • Adolescent
  • Adult
  • Blepharoptosis (surgery)
  • Eyelids (pathology, surgery)
  • Female
  • Humans
  • Lacrimal Apparatus
  • Male
  • Middle Aged
  • Pupil
  • Reference Values
  • Young Adult

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