Rethinking Our Definition of Postoperative Success: A Comparative Analysis of Three Upper Eyelid Retraction Repair Techniques Using Novel Metrics to Capture Functional and Aesthetic Outcomes

Abstract

Each technique appropriately lowered the eyelid and improved contour without intertechnique variability. Septum-preserving techniques demonstrated less iTPS elongation initially, but this difference was not maintained. The visible eyelid crease height (pupil to visible eyelid crease) remained stable in all techniques, indicating that the iTPS elongation seen with each technique was secondary to reduction in iMRD1 and the iBFS reduction seen with septum-opening levator recession with Muellerectomy was due to brow descent. No intertechnique differences in the amount of iTPS elongation relative to iMRD1 reduction (i.e., the novel iTPS-minimizing power) were seen. Given that each procedure evaluated yielded similar results, technique selection may be guided by surgeon experience and preference.

Aesthetic Eyelid Measurements of “Beautiful People”: Gender Differences and Application for Thyroid Eye Disease Patients

“…However, the mean iTPS:iBFS ratio for female celebrities was smaller than that of postoperative TED patients, which is likely a result of TPS elongation resulting from eyelid retraction repair. 1 Other studies have analyzed aesthetic measurements of the periocular structures and their relationships.…”

“…However, the postoperative time period was discontinued and the final measurements were obtained if a patient underwent any eyelid-altering therapy (including surgery), received any disease-modifying agents (including corticosteroids) or orbital radiation therapy, or experienced a flare of TED during the follow-up period. 1 Due to the limited number of male patients who underwent TED-related upper eyelid repair during the same period, male patients were not included for comparison with male celebrities. Statistical analyses comparing mean values between female and male celebrities, and between female celebrities and female TED patients were performed utilizing a Wilcoxon signed-rank test.…”

“…[1][2][3][4][5][6][7] In addition, anatomical relationships are important to the perception of the eyelid, eyebrow, and adnexa, and the ratio of these metrics has been established as a key contributor to upper eyelid and eyebrow aesthetics. 1,[3][4][5][6][7][8] The TPS-to-BFS (TPS:BFS) ratio, for example, has been identified as one such key contributor to eyelid and eyebrow aesthetics. 4 However, despite the variety of metrics used to determine aesthetic outcomes, there remains a paucity of studies investigating the measurements of periocular structures and relationships of people popularly seen as "beautiful."…”

“…The purpose of this study was to better understand the aesthetic metrics of the eyelid and adnexa in the United States by (1) identifying the mean and range of marginal Disclosure: All the authors have no financial interest in relation to the content of this article. This study was supported by an unrestricted grant from Research to Prevent Blindness, Inc. New York, N.Y.…”

The Effect of Teprotumumab on Eyelid Position in Patients with Thyroid Eye Disease

“…Images were analyzed with NIH ImageJ software (version 1.5) to obtain image-derived MRD1 and MRD2. 5 …”