Starck W J, Griffin J E, Epker B N
Department of Oral and Maxillofacial Surgery, John Peter Smith Hospital, Fort Worth, TX, USA.
J Oral Maxillofac Surg. 1996 Mar;54(3):297-302; discussion 302-3. doi: 10.1016/s0278-2391(96)90746-6.
Surgery of the upper and lower eyelids and eyebrows is primarily designed to enhance the esthetic appearance and provide functional visual field benefits. Paramount to successful surgical results is a carefully executed examination and treatment plan. The preoperative and postoperative evaluation of these individuals has been primarily subjective. This article describes a method for the quantification of periorbital relationships that is of use in the preoperative planning and postoperative evaluation of patients undergoing esthetic surgery of the eyelids and eyebrows.
The photographic records of 15 female patients who had undergone bilateral upper eyelid surgery were examined. None of the patients underwent lower eyelid or eyebrow surgery. Preoperative and postoperative frontal photographs were projected to a standard size, and measurements were made in a standardized fashion. For the comparison of intrapatient and interpatient relationships, objective anthropometric proportions rather than average measurements were used. Therefore, standard periorbital relationships were recorded and expressed as anthropometric ratios. Measurements were recorded for 30 eyes. The preoperative and postoperative relationships were measured and reported as mean values with standard deviation. The relationships studied were: 1) Upper lid height to orbit height, 2) Lower lid height to orbit height, 3) Lid sulcus height to orbit height, 4) Lid sulcus height to upper lid height, 5) Upper iris coverage to iris height, 6) Lower iris coverage to iris height, 7) Orbit height to middle facial height, 8) Medial brow to orbit height, 9) Lateral brow to orbit height, and 10) Eye fissure height to orbit height. Brow heights were measured vertically from a line connecting exocanthion and endocanthion.
The postoperative changes in these patients showed the following: Upper lid height, eye fissure height, and brow position were not significantly affected by upper lid blepharoplasty surgery. The sulcus lid height was doubled postoperatively, and upper iris coverage was decreased slightly postoperatively.
The results of the study indicate that the proposed methodology is appropriate for the objective evaluation of periorbital relationships pertinent to esthetic periorbital surgery. Its use is suggested as a diagnostic aid in preoperative planning and postsurgical evaluation.
上下眼睑及眉毛手术主要旨在改善美观并提供功能性视野益处。成功的手术结果至关重要的是精心执行的检查和治疗计划。对这些患者的术前和术后评估主要是主观的。本文描述了一种用于量化眶周关系的方法，该方法在眼睑和眉毛美容手术患者的术前规划和术后评估中有用。
检查了15例接受双侧上睑手术的女性患者的照片记录。所有患者均未接受下睑或眉毛手术。术前和术后的正面照片投影至标准尺寸，并以标准化方式进行测量。为了比较患者内和患者间的关系，使用客观人体测量比例而非平均测量值。因此，记录标准眶周关系并表示为人体测量比率。对30只眼睛进行了测量。术前和术后关系经测量并报告为均值及标准差。研究的关系包括：1）上睑高度与眶高，2）下睑高度与眶高，3）睑沟高度与眶高，4）睑沟高度与上睑高度，5）上虹膜覆盖与虹膜高度，6）下虹膜覆盖与虹膜高度，7）眶高与中面部高度，8）眉内侧与眶高，9）眉外侧与眶高，以及10）睑裂高度与眶高。眉高从连接外眦和内眦的线垂直测量。
这些患者术后变化如下：上睑高度、睑裂高度和眉位置在上睑成形术后未受到显著影响。睑沟高度术后翻倍，上虹膜覆盖术后略有下降。
研究结果表明，所提出的方法适用于对与眶周美容手术相关的眶周关系进行客观评估。建议将其用作术前规划和术后评估的诊断辅助手段。
