Eckstein Lauren A, Shadpour Joseph M, Menghani Ravi, Goldberg Robert A
Scheie Eye Institute, University of Pennsylvania School of Medicine, Philadelphia, USA.
Arch Facial Plast Surg. 2011 Jan-Feb;13(1):51-6. doi: 10.1001/archfacial.2010.102.
To present a novel method for accurately characterizing the position of the globe relative to the orbital rim. The appearance and function of the eyelids are dependent on the underlying orbital bony architecture and globe position; however, no comprehensive language to describe these complex 3-dimensional relationships exists.
Three-dimensional orbital reconstructions were generated from computed tomographic scans of 15 Occidental and 12 Oriental orbits without orbital pathologic disease. Globe and orbital rim anatomy were identified and outlined. Reference points were measured along 2 independent axes: (1) the distance between a plane defined by the corneal apex and the sagittal projection of the orbital rim and (2) the distance between the circumference of the globe and the coronal projection of the orbital rim.
For Occidental orbits, the mean (SD) elevation of the sagittal projection of the orbital rim relative to the anterior projection of the globe was 4.6 (4.2) mm superiorly, 5.9 (3.0) mm nasally, 12.6 (3.7) mm inferiorly, and 20.6 (2.6) mm laterally. The mean (SD) radial distance between the coronal projection of the orbital rim and the circumference of the globe was 3.7 (2.1) mm superiorly, 7.6 (1.8) mm nasally, 6.6 (2.2) mm inferiorly, and 4.6 (2.3) mm laterally. For Oriental orbits, the mean (SD) elevation of the sagittal projection of the orbital rim relative to the anterior projection of the globe was 5.0 (4.5) mm superiorly, 6.8 (4.1) mm nasally, 11.1 (4.3) mm inferiorly, and 17.5 (3.3) mm laterally. The mean (SD) radial distance between the coronal projection of the orbital rim and the circumference of the globe was 2.1 (1.2) mm superiorly, 8.2 (2.0) mm nasally, 6.5 (1.9) mm inferiorly, and 4.5 (1.7) mm laterally.
Comparison of Occidental and Oriental orbital rim and globe configurations revealed quantitative and qualitative differences. In addition to differences in soft-tissue anatomy, bony architectural variations may contribute substantially to racial differences in the surface anatomy of the periorbital area. Anatomic analysis, based on 3-dimensional orbital imaging, may provide a rational approach to surgical planning for aesthetic and reconstructive orbitofacial surgery.
提出一种精确描述眼球相对于眶缘位置的新方法。眼睑的外观和功能取决于其下方的眶骨结构和眼球位置；然而，目前尚无全面的语言来描述这些复杂的三维关系。
对15例西方人和12例东方人无眼眶病变的眼眶进行计算机断层扫描，生成三维眼眶重建图像。识别并勾勒出眼球和眶缘的解剖结构。沿着两条独立的轴测量参考点：（1）由角膜顶点定义的平面与眶缘矢状投影之间的距离；（2）眼球圆周与眶缘冠状投影之间的距离。
对于西方人眼眶，眶缘矢状投影相对于眼球前投影的平均（标准差）抬高为：上方4.6（4.2）mm，鼻侧5.9（3.0）mm，下方12.6（3.7）mm，外侧20.6（2.6）mm。眶缘冠状投影与眼球圆周之间的平均（标准差）径向距离为：上方3.7（2.1）mm，鼻侧7.6（1.8）mm，下方6.6（2.2）mm，外侧4.6（2.3）mm。对于东方人眼眶，眶缘矢状投影相对于眼球前投影的平均（标准差）抬高为：上方5.0（4.5）mm，鼻侧6.8（4.1）mm，下方11.1（4.3）mm，外侧17.5（3.3）mm。眶缘冠状投影与眼球圆周之间的平均（标准差）径向距离为：上方2.1（1.2）mm，鼻侧8.2（2.0）mm，下方6.5（1.9）mm，外侧4.5（1.7）mm。
西方人和东方人眶缘与眼球形态的比较揭示了数量和质量上的差异。除了软组织解剖结构的差异外，骨结构的变化可能在很大程度上导致眶周区域表面解剖结构的种族差异。基于三维眼眶成像的解剖分析可为眼眶面部美容和重建手术的手术规划提供合理的方法。
