Department of Plastic and Reconstructive Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng District, Beijing, People's Republic of China.
Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng District, Beijing, People's Republic of China.
Aesthetic Plast Surg. 2023 Dec;47(6):2453-2460. doi: 10.1007/s00266-023-03474-0. Epub 2023 Jul 24.
Existing evaluation tools of tear trough deformity are based on subjective impression of clinicians. More accurate quantitative assessment methods are needed. This study aimed to propose a quantitative three-dimensional assessment method for the tear trough deformity in comparison with the Barton's grading system and apply it to the efficacy evaluation of orbital septum fat transposition.
117 healthy Chinese adults (234 eyes) were enrolled and divided into four groups according to the Barton's grading system. Three-dimensional facial images were captured using Vectra H1 handheld camera. 6 anthropometric landmarks were identified on each eye and 8 linear measurements were generated accordingly. Intra-observer reliability was determined and measurements were compared between groups. Pre- and post-operative three-dimensional measurements were compared in 19 patients who received lower blepharoplasty with orbital septum fat transposition.
The severity of tear trough was positively correlated with age (P < 0.001) but not BMI (P = 0.145) or gender (P = 0.280). Intra-rater reliability of the 8 linear measurements was excellent except for the vertical distance between the palpebrale inferioris margin and the tear trough below the pupillary center. Intergroup comparison showed that the horizontal distance between the lateral end of tear trough (P < 0.001) and medial canthus and the sagittal vector from tear trough point toward eyelid bag point (P = 0.009) increased with grade, while the vertical distance from mid-pupil to palpebrale inferioris margin decreased gradually (P = 0.001). Orbital septum fat transposition significantly improved the tear trough deformity as assessed by these three-dimensional measurements.
We demonstrated a novel quantitative evaluation method of the tear trough deformity using three-dimensional stereophotogrammetry and proved it to be valid and reliable. It showed good value of clinical application and might help with periorbital rejuvenation planning and outcome assessment.
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现有的泪槽畸形评估工具都是基于临床医生的主观印象。需要更准确的定量评估方法。本研究旨在提出一种定量的三维评估泪槽畸形的方法，并与巴顿分级系统进行比较，应用于眶隔脂肪转位的疗效评估。
纳入 117 名健康的中国成年人（234 只眼），根据巴顿分级系统分为四组。使用 Vectra H1 手持相机拍摄三维面部图像。在每只眼睛上识别 6 个人体测量标志点，并生成相应的 8 条线性测量值。确定组内观察者的可靠性，并对各组间的测量值进行比较。对 19 例接受下睑成形术联合眶隔脂肪转位的患者进行术前和术后三维测量。
泪槽的严重程度与年龄呈正相关（P<0.001），但与 BMI（P=0.145）或性别（P=0.280）无关。8 条线性测量值的组内观察者可靠性均为优，除了瞳孔中心下方下睑缘与泪槽之间的垂直距离外。组间比较显示，泪槽外侧端的水平距离（P<0.001）和内眦与泪槽点向眼袋点的矢状向量（P=0.009）随分级增加而增加，而瞳孔中点至下睑缘的垂直距离逐渐减小（P=0.001）。眶隔脂肪转位明显改善了三维测量评估的泪槽畸形。
我们使用三维体视摄影术展示了一种新的泪槽畸形定量评估方法，并证明其具有有效性和可靠性。它具有良好的临床应用价值，可能有助于眶周年轻化的规划和效果评估。
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