John F. Hardesty MD, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, U.S.A.
Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, U.S.A.
Ophthalmic Plast Reconstr Surg. 2022;38(5):438-443. doi: 10.1097/IOP.0000000000002145. Epub 2022 Mar 21.
The presence of eyebrow elevation in anophthalmic patients has been used as evidence to support a proprioceptive stimulus for frontalis innervation. In this study, we examined the frequency of brow elevation before and after enucleation and reviewed additional clinical findings to determine if any were associated with eyebrow position.
A retrospective study was performed on 134 anophthalmic patients. Demographics, measurements, and photographs were reviewed. Reference photographs were used to subjectively grade brow position and sulcus depth.
Preoperative eyebrow elevation was present in 56.2% of patients without blepharospasm from a painful eye, of who 62% had chronic visual loss. Ipsilateral ptosis (p = 0.008), deep superior sulcus (p < 0.001), and right-sided pathology (p = 0.045) were more common in patients with brow elevation. Symmetrically elevated brows were more frequent before right than left enucleation (p = 0.05). Brow position remained stable after 61.9% of procedures. While often mild, postoperative brow elevation was seen in 31.0% of patients without preoperative elevation. Deepening of the superior sulcus was more common in patients with new relative brow elevation (p = 0.031). Anophthalmic ptosis and right-left surgical side were not associated with new postoperative brow elevation.
Eyebrow elevation was often present prior to enucleation and associated with an increased occurrence of ptosis, superior sulcus deepening, and right-sided pathology. Intact vision was not needed to maintain an elevated brow. Superior sulcus deepening, but not ptosis, was more common in patients developing new postoperative brow elevation. The findings support both proprioceptive and compensatory mechanisms for eyebrow elevation.
无眼球患者的眉弓抬高曾被用作额肌神经支配的本体感觉刺激的证据。本研究通过检查眼球摘除术前和术后眉弓抬高的频率，并回顾其他临床发现，以确定是否有任何发现与眉弓位置相关，从而对此进行了研究。
对 134 例无眼球患者进行了回顾性研究。对患者的人口统计学资料、测量值和照片进行了评估。使用参考照片对眉弓位置和眶上沟深度进行了主观分级。
在没有因疼痛而导致的眼肌痉挛的患者中，术前有 56.2%的患者存在眉弓抬高，其中 62%的患者有慢性视力丧失。同侧上睑下垂（p = 0.008）、深上眶沟（p < 0.001）和右侧病变（p = 0.045）在眉弓抬高的患者中更为常见。右侧比左侧眼球摘除时，对称抬高的眉弓更为常见（p = 0.05）。61.9%的手术患者术后眉弓位置保持稳定。尽管通常很轻微，但在术前无抬高的患者中，有 31.0%的患者出现了术后眉弓抬高。新出现相对眉弓抬高的患者中，眶上沟加深更为常见（p = 0.031）。无眼球性上睑下垂和左右手术侧与新出现的术后眉弓抬高无关。
眉弓抬高常发生在眼球摘除之前，并与上睑下垂、眶上沟加深和右侧病变的发生率增加有关。完整的视力并非维持眉弓抬高所必需。与上睑下垂相比，眶上沟加深在出现新的术后眉弓抬高的患者中更为常见。这些发现支持了眉弓抬高的本体感觉和代偿机制。
