A novel standardized distraction test to evaluate lower eyelid tension using three-dimensional stereophotogrammetry

Abstract

Background: Standardized pre-operative assessment of the lower eyelid tension is essential to determine the optimal surgical technique. However, quantitative analysis using the conventional distraction test is inaccurate and user-dependent. Our purpose was to introduce a novel, standardized three-dimensional distraction test for measuring lower eyelid tension and to determine its standard values in a Caucasian population.Methods: In 94 participants (50 men and 44 women; age 21-85 years), a 15.9-g weighted eyelid hook was used to pull down the lower eyelid. Two three-dimensional images were acquired with a VECTRA M3 stereophotogrammetry device-one in the neutral position without a hook and the other in the distracted position with the eyelid hook. The images of all participants in both positions were measured twice by a single observer.Results: There was no clinical (>1 mm) or statistically significant difference between the two repeated measurements of all the inter-landmark linear distances in both positions (P≥0.05, respectively). The mean distracted displacement between the neutral and distracted position for margin reflex distance was 5.50±1.53 mm, without any age-specific difference (P=0.08); however, a significant gender-specific difference was observed as men had significantly greater displacement than women (P<0.001).Conclusions: Our proposed standardized three-dimensional distraction test for assessing lower eyelid tension using an eyelid hook and a simple landmark-based system seems to provide high reliability. This novel and simple method might be helpful for the preoperative planning of eyelid surgeries.

Grand Challenges and Opportunities in Surgical Ophthalmology: Together for a Shared Future

“…A number of recent papers have used AI for eyelid and periorbital measurements (91,92). A similar approach could be used to classify periorbital lesions with 3D stereophotogrammetry and apply AI analysis to aid in diagnosis and triage (93)(94)(95)(96)(97)(98).…”

A novel standardized approach for the 3D evaluation of upper eyelid area and volume

“…The eyes and the periocular region, especially the eyelids, are the most prominent anatomical structures in the center of the face, attracting increasing interest in surgical or nonsurgical esthetic procedures to improve an undesired appearance or correct deformities (1). As introduced by Farkas (2), standardized facial anthropometric analysis has become widespread for disease diagnosis, preoperative evaluation, surgical planning, and postoperative followup (3)(4)(5). Moreover, since aesthetic assessment and disease diagnosis are comprehensive and holistic assessments to a certain extent, it is necessary to evaluate the 3-dimensional (3D) holistic contours and topological surfaces (i.e., area and volume).…”

Validation of the Portable Next-Generation VECTRA H2 3D Imaging System for Periocular Anthropometry

“…Most of the existing 3D photogrammetry systems are static devices, which prominently feature in capturing photos of participants from three different angles at a single time point and composing a 3D photo using a computer. Previous studies have proposed the first standardized periocular anthropometric protocol ( 17 , 18 ) and showed potential clinical applications, including a novel standardized lower eyelid tension distraction test and a lateral distraction test ( 19 , 20 ). The reliability (repeatability) and accuracy of the VECTRA M3 static device is very high for linear, curvilinear, angular, area, and volume measurements ( 21 – 25 ).…”