Michigan State University College of Human Medicine, Department of Surgery, Grand Rapids, Michigan, USA.
Ophthalmic Plast Reconstr Surg. 2012 Jan-Feb;28(1):50-3. doi: 10.1097/IOP.0b013e3182364aea.
To examine the relation between asymmetric eyebrow elevation and ocular dominance.
A retrospective cohort study was performed in patients who underwent bilateral upper eyelid blepharoplasty from July 2007 to May 2009. Patients with pre- and postoperative involuntary asymmetric eyebrow elevation were selected from a surgical log database for inclusion in this study. Brow asymmetry was determined by examination of preoperative and postoperative digital photographs and was defined as a measured eyebrow-height difference in conjunction with the asymmetric recruitment of the frontalis muscle. Ocular dominance was determined by using a modified Porta test. Statistical analysis was performed by using the Fisher Exact test.
Forty-seven patients met inclusion criteria. Sixty-six percent (31 of 47) involuntarily, asymmetrically elevated the right eyebrow, and 34% (16 of 47), the left. Of the 31 patients with right eyebrow elevation, 87% (27 of 31) were right-eye dominant, and 13% (4 of 31) were left-eye dominant (p < 0.001). Among patients with asymmetric left eyebrow elevation, 62.5% (10 of 16) were left-eye dominant, whereas only 37.5% (6 of 16) patients were right-eye dominant (p < 0.001).
We report for the first time that involuntary asymmetric eyebrow elevation and ocular dominance are significantly associated. The assessment of ocular dominance should be included in the pre- and postoperative evaluation of patients with asymmetric brow elevation undergoing blepharoplasty. This asymmetry and its etiology must be recognized, so that an attempt to create symmetry does not result in the overcorrection of the contralateral eyelid that may lead to complications such as lagophthalmos and exposure keratopathy.
研究眉弓不对称抬高与眼优势的关系。
本研究为回顾性队列研究，纳入 2007 年 7 月至 2009 年 5 月间行双侧上睑成形术的患者。从手术日志数据库中选择术前和术后出现非自愿性、不对称性眉弓抬高的患者纳入本研究。通过术前和术后数字照片检查来确定眉弓不对称，定义为测量的眉毛高度差异伴额肌不对称募集。通过改良 Porta 试验确定眼优势。采用 Fisher 精确检验进行统计学分析。
47 例患者符合纳入标准。66%（31/47）的患者右侧眉弓非自愿性、不对称性抬高，34%（16/47）的患者左侧眉弓非自愿性、不对称性抬高。31 例右侧眉弓抬高的患者中，87%（27/31）为右眼优势，13%（4/31）为左眼优势（p<0.001）。16 例左侧眉弓不对称抬高的患者中，62.5%（10/16）为左眼优势，而仅有 37.5%（6/16）为右眼优势（p<0.001）。
我们首次报道，非自愿性不对称眉弓抬高与眼优势显著相关。在接受上睑成形术的眉弓不对称抬高患者的术前和术后评估中，应评估眼优势。必须认识到这种不对称及其病因，以避免试图使双侧对称时，导致对侧眼睑过度矫正，从而引发诸如睑裂闭合不全和暴露性角膜炎等并发症。
