Hou Xiao-Yi, Rokohl Alexander C, Meinke Marius M, Li Sen-Mao, Lin Ming, Jia Ren-Bing, Guo Yong-Wei, Heindl Ludwig M
Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne 50937, Nordrhein-Westfalen, Germany.
Int J Ophthalmol. 2022 Nov 18;15(11):1757-1764. doi: 10.18240/ijo.2022.11.05. eCollection 2022.
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).
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.
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.
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.
探讨改良三维牵拉试验（3D-DT）和三维捏持试验（3D-PT）评估下睑张力（LET）的可靠性。
对97名志愿者（共97只眼睑）进行横断面研究，这些志愿者无创伤、肿瘤或重建手术史。为每位参与者采集六张三维照片，包括两张中立位（NP）照片、两张使用15.9克不锈钢眼睑钩进行改良3D-DT的照片以及两张使用3D-PT的照片。
NP、3D-DT和3D-PT测量值之间的平均绝对差异分别在0.07至7.42、0.10至13.10以及0.07至15.97之间；测量技术误差分别在0.05至7.81、0.09至10.19以及0.07至12.47之间；相对误差测量值分别在0.10%至11.50%、0.16%至30.51%以及0.11%至38.75%之间。对于评分者内信度，在NP和3D-DT获得的八项测量中，有七项的组内相关系数（ICC）大于0.80，而评分者1在3D-PT中获得的ICC低至小于0.30；评分者2在所有位置（NP、3D-DT和3D-PT）获得的所有测量的ICC均大于0.80。对于评分者间信度，八项NP和3D-DT测量中有六项的ICC大于0.80，而3D-PT测量的ICC小于0.30。对于方法内信度，所有NP测量的ICC均大于0.87，而六项3D-DT测量和四项3D-PT测量的ICC均大于0.80。
我们的研究结果证明，使用眼睑钩的改良3D-DT可成为评估LET的高度可靠方法。此外，这种新颖且简单的方法可作为进一步研究以及术前和术后常规临床评估的基础。
