Lower Eyelid Tension in Young Adults Determined by a Simple Lid Tensiometer

Fu, Zhi-xuan; Zhang, Xing Ru; Zhang, Zhen-Yong; Li, Qingsong; Wang, Hanmin; Xiang, Minhong; Han, Zhu-mei

doi:10.1097/ico.0000000000000079

Cited by 8 publications

(9 citation statements)

References 12 publications

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“…However, we have not measured these pressures. The pressures and viscoelasticity of the eyelid and cornea have been measured previously using a lid tensiometer65 and microindentation method, respectively 66. Future studies will aim to adjust the parameters of the blink to match physiological pressures.…”

Section: Discussionmentioning

confidence: 99%

Development of an Eye Model With a Physiological Blink Mechanism

Phan

Walther

Qiao

et al. 2019

Trans. Vis. Sci. Tech.

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Purpose To develop an eye model with a physiological blink mechanism. Methods All parts of the eye model were designed using computer-aided design software. The eyelid consisted of a unique 3D printed structure containing teeth to physically secure a flexible membrane. Both the eyeball and eyelid membrane were synthesized using polyvinyl alcohol (PVA). Four molecular weights of PVA (89–98, 85–124, 130, and 146–186 kDa) were tested at a range of concentrations between 5% and 30% weight/volume. The wettability and water content of these materials were compared with the bovine cornea and sclera. The model was connected to a microfluidic pump, which delivers artificial tear solution (ATS) to the eyelid. A corneal topographer was used to evaluate the tear break-up and tear film regeneration. Results The eyelid flexes and slides across the eyeball during each blink, which ensures direct contact between the two surfaces. When loaded with an ATS, this mechanism evenly spreads the solution over the eyeball to generate an artificial tear film. The artificial tear film in this eye model had a tear break-up time (TBUT) of 5.13 ± 0.09 seconds at 1.4 μL/min flow rate, 6 blinks/min, and <25% humidity. Conclusions This model simulates a physiological blink actuation and an artificial tear film layer. Future studies will examine variations in flow rates and ATS composition to simulate clinical values of TBUT. Translational Relevance The eye model could be used to study in vitro TBUT, tear deposition, and simple drug delivery.

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Section: Discussionmentioning

confidence: 99%

Development of an Eye Model With a Physiological Blink Mechanism

Phan

Walther

Qiao

et al. 2019

Trans. Vis. Sci. Tech.

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“…T he pressure exerted on the eyes by the eyelids is defined as horizontal eyelid tension [1] . Although several factors can cause eyelid malposition [2] , senile involution can significantly weaken horizontal palpebral traction and eventually decrease lower eyelid tension (LET) [3] .…”

Section: Introductionmentioning

confidence: 99%

“…The degree of laxity is considered normal if the distracted distance is less than 2 mm from the cornea; values higher than 6 mm are considered to indicate laxity. Over time, numerous studies have been conducted to evaluate the use of various devices for the assessment of LET [1,[9][10][11][12][13] . However, most of these instruments, including the clamp and latex sensor, were considered infeasible due to their highly variable displacement distances and the overestimated LET values [1,9] .…”

Section: Introductionmentioning

confidence: 99%

“…Over time, numerous studies have been conducted to evaluate the use of various devices for the assessment of LET [1,[9][10][11][12][13] . However, most of these instruments, including the clamp and latex sensor, were considered infeasible due to their highly variable displacement distances and the overestimated LET values [1,9] . With the dramatic development of high-resolution threedimensional (3D) stereophotogrammetry, the digital system has been utilized in the measurement of the normal anthropometric parameters of the cranial, facial, and periocular regions and in the planning of the optimal procedure for reconstructive eyelid surgeries [14][15] .…”

Section: Introductionmentioning

confidence: 99%

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A modified 3D stereophotogrammetry-based distraction test for assessing lower eyelid tension

Hou¹,

Meinke²,

Li³

et al. 2022

Int J Ophthalmol

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AIM: To investigate the reliability of a modified three-dimensional distraction test (3D-DT) and three-dimensional pinch test (3D-PT) for assessing lower eyelid tension (LET). METHODS: A cross-sectional study was conducted among 97 volunteers including 97 eyelids with no history of trauma, tumor, or reconstructive surgeries. Six three-dimensional photographs were acquired for each participant, including two photographs obtained in a neutral position (NP), two using a modified 3D-DT with a 15.9-grammes stainless steel eyelid hook performed, and two using 3D-PT. RESULTS: The mean absolute differences between NP, 3D-DT, and 3D-PT measurements varied between 0.07 and 7.42, 0.10 and 13.10, and 0.07 and 15.97, respectively; technical error of measurement varied between 0.05 and 7.81, 0.09 and 10.19, and 0.07 and 12.47, respectively; and relative error measurements varied between 0.10% and 11.50%, 0.16% and 30.51%, and 0.11% and 38.75%, respectively. For intra-rater reliability, the intraclass correlation coefficients (ICCs) were more than 0.80 in seven out of eight measurements obtained in the NP and 3D-DT, whereas those obtained in the 3D-PT were as low as less than 0.30 by rater 1; the ICCs of all the measurements obtained in all the positions (NP, 3D-DT, and 3D-PT) were more than 0.80 by rater 2. For inter-rater reliability six out of eight NP and 3D-DT measurements had an ICC greater than 0.80, whereas those of 3D-PT measurements were less than 0.30. For intra-method reliability, the ICCs of all the NP measurements were more than 0.87, whereas those of the six 3D-DT measurements and four 3D-PT measurements were more than 0.80. CONCLUSION: Our study results prove that the modified 3D-DT, which involves the use of an eyelid hook, can be a highly reliable method for evaluating LET. Furthermore, this novel and simple method may be utilized as the basis for further investigation and routine pre- and postoperative clinical evaluation.

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“…Pre-operative assessment of LET is particularly important to determine the optimal surgical technique (4). Previously, several studies have investigated the use of various devices to estimate LET (4)(5)(6)(7)(8)(9). However, most of these instruments, such as the clamp placed on the eyelid margin and latex sensor inserted into the inferior fornix, were not feasible for use (4).…”

Section: Introductionmentioning

confidence: 99%

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

Hou¹,

Rokohl²,

Meinke³

et al. 2021

Quant Imaging Med Surg

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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.

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Lower Eyelid Tension in Young Adults Determined by a Simple Lid Tensiometer

Abstract: Our simple lid tensiometer is a viable option for measuring eyelid pressure with good repeatability.

Cited by 8 publications

References 12 publications

Development of an Eye Model With a Physiological Blink Mechanism

Development of an Eye Model With a Physiological Blink Mechanism

A modified 3D stereophotogrammetry-based distraction test for assessing lower eyelid tension

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

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