Clinic of Plastic and Reconstructive Surgery, Academic Hospital of Udine, DAME Department of Medical Area, University of Udine, Italy.
Hygiene and Clinical Epidemiology, University Hospital of Udine, ASUI Udine, Istituto Igiene, P.zzale S. Maria Misericordia 1,Udine, Italy.
Ophthalmic Plast Reconstr Surg. 2019 Jul/Aug;35(4):333-341. doi: 10.1097/IOP.0000000000001247.
Several anatomical and physio-pathologic studies of eyelid region have allowed the creation of theories on facial tissues aging dynamics, which have not been clarified yet. We assessed the signs of aging in the region over the time by observing the characteristics in the same person at different times of his/her life.
We compared the position of the main anatomical landmarks of the eyelid region of 80 patients by overlaying their photographs when they were 20, 40, and 60 years old. Then we made comparisons in the group of men (40 people) and in the group of women (40 people) and between men and women.
The medial portion of the eyebrow was higher in the photograph taken at 60 years of age than in the one taken at 20 years old in 56.2% of cases; it was higher in 47.5% of cases when comparing the images at 20 and 40. The lateral portion of the eyebrow was seen higher in women in the 20 to 40 group, and it was seen lower in men at 60 years in statistical significance. In more than half of the patients observed, there was not a real descent of the eyebrow and the presence of a more or less accentuated form of upper eyelid's ptosis in the photograph at 60 (globally 47.5%, 55.0% of women and 40.0% of men). This condition was observed in 27.5% of the photographs at 40. There were changes in the horizontal dimension of the palpebral fissure (shortening in 53.7%, preserved in 33.7%, and increased in 12.5% of cases at 60 years old). The position of lateral canthus appeared lower in 40.0% of patients photographed at 60, but it was stable in those photographed at 40. The herniation of the upper eyelid bags was observed in 31.2% of the patients photographed at 60 years old but only in 13.7% at 40. Dermatochalasis of the upper eyelid was present in 67.5% of the people at 60 years old and in 55.0% of those seen when they were 40. Comparing men and women groups 20 to 40, dermatochalasis is more present in men than women at 40 years old with statistical significance. The eyelid-cheek junction was seen to be lower in 75.0% of cases at 60 and in 48.7% of cases at 40, and it is more represented in men than in women.
We have highlighted some interesting elements, partly agreeing with the data already recorded by other authors', and our data suggest an important role of the eyelid structures senescence and its impact on the surrounding structures.
对眼睑区域的几项解剖学和生理病理学研究，使人们对面部组织老化动态的理论有了更深入的了解，但这些理论仍未得到明确阐述。本研究通过观察同一人在不同生命阶段的特征，来评估随着时间的推移，该区域的老化迹象。
我们对比了 80 名患者在 20 岁、40 岁和 60 岁时的照片，以叠加的方式比较眼睑区域的主要解剖标志位置。然后，我们在男性（40 人）和女性（40 人）组以及男性和女性组之间进行了比较。
在 56.2%的病例中，60 岁时拍摄的照片中眉毛内侧部分高于 20 岁时拍摄的照片；在 20 岁和 40 岁的图像比较中，有 47.5%的病例是这种情况。在 20 至 40 岁组中，女性的眉毛外侧部分看起来更高，而在统计学上，60 岁的男性眉毛则看起来更低。在观察到的超过一半的患者中，眉毛并没有真正下垂，而是在 60 岁时的照片中出现了或多或少明显的上睑下垂（总体为 47.5%，女性为 55.0%，男性为 40.0%）。这种情况在 40 岁时的照片中观察到 27.5%。睑裂的水平维度发生了变化（53.7%的病例缩短，33.7%的病例保持不变，12.5%的病例增加）。在 60 岁时拍摄的照片中，有 40.0%的患者外眦位置较低，但在 40 岁时拍摄的照片中，外眦位置稳定。上睑袋疝出在 60 岁时拍摄的照片中观察到 31.2%的患者，但在 40 岁时拍摄的照片中仅观察到 13.7%的患者。上睑皮肤松弛在 60 岁时观察到 67.5%的人，在 40 岁时观察到 55.0%的人。比较 20 至 40 岁的男性和女性组，40 岁时男性的皮肤松弛比女性更明显，具有统计学意义。在 60 岁时拍摄的照片中，有 75.0%的患者下睑和颊部交界处较低，在 40 岁时拍摄的照片中，有 48.7%的患者下睑和颊部交界处较低，而且这种情况在男性中比女性更常见。
我们发现了一些有趣的元素，这些元素在一定程度上与其他作者已经记录的数据一致，并且我们的数据表明眼睑结构老化及其对周围结构的影响起着重要作用。
