MODIFICATION OF EYEBROW ASYMMETRY FOLLOWING UNILATERAL SURGERY FOR INVOLUTIONAL PTOSIS
Author: Matteo Barchitta
Base Hospital / Institution: Tiberia Hospital – GVM care and Research – Rome – Italy
ePoster presentation
Abstract ID: 24-314
Purpose
To analyse the brow position and shape following correction of unilateral involutional ptosis with anterior approach levator advancement (ALR) and posterior approach conjunctivo-müllerectomy (MMCR).
Methods
Retrospective review of patients with unilateral ptosis and preoperative eyebrow asymmetry submitted to ALR or MMCR by 3 senior surgeons. Exclusion criteria included previous eyelid or brow surgery, trauma, facial palsy, thyroid eye disease, botulinum toxin injection in the upper third of the face in the last 6 months, congenital ptosis and poor levator function (<7mm). All patients had a follow up of at least 3 months.
Pre- and postoperative Margin Reflex Distance 1 (MRD1), Pupil to Brow Distance (PBD), brow contour and symmetry (Bezier Curve) were evaluated and compared between the two groups using standardised photos and the image processing program ImageJ. Statistical analysis was validated by Wilcoxon test.
Results
Twenty-three patients met the inclusion criteria, and of them 18 (78.2%) were females. The median age was 50.6 years. Fifteen patients were submitted to ALR, and 8 patients to MMCR. There was a statistically significant increase in MRD1 (p<0.01) following both ALR and MMCR. The eyebrow ipsilateral to the side of the ptosis had a statistically significant descend (p<0.01) in both groups following surgery.
The analysis of the Bezier Curve at 3 months showed an improvement in the symmetry of the two eyebrows in 73.3% of patients submitted to unilateral ALR, and in 50% of patients submitted to MMCR.
Conclusion
Tonic or chronic eyebrow elevation has been variably associated with ptosis, and a change in brow position following surgery is a common finding. Both ALR and MMCR are effective in repositioning the eyebrow after ptosis surgery.
Additional brow procedures should be performed only after at least 3 months of follow-up, when the brow position is unlikely to change.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Ana | Duarte | Tiberia Hospital – GVM care and Research – Rome – Italy |
| Martin | Devoto | Tiberia Hospital – GVM care and Research – Rome – Italy |
| Marco | Sales Sanz | Tiberia Hospital – GVM care and Research – Rome – Italy |
| Francesco | Quaranta Leoni | Tiberia Hospital – GVM care and Research – Rome – Italy |
