Article ; Online: Upper Eyelid Retraction in Graves' Ophthalmopathy: Our Surgical Experience on 153 Cases of Full-Thickness Anterior Blepharotomy with Mullerectomy.
2022 Volume 46, Issue 4, Page(s) 1713–1721
Abstract: Background: We present our experience on 153 cases of full-thickness anterior blepharotomy with mullerectomy (FTABM) in the treatment of upper eyelid retraction (UER) related to Graves' ophthalmopathy (GO).: Methods: We included all the patients who ... ...
| Abstract | Background: We present our experience on 153 cases of full-thickness anterior blepharotomy with mullerectomy (FTABM) in the treatment of upper eyelid retraction (UER) related to Graves' ophthalmopathy (GO). Methods: We included all the patients who underwent a graded FTABM between 1<sup>st</sup> January 2015 and 30<sup>th</sup> June 2020 for UER GO-related. The analysis included: pre-/post-operative conjunctival symptoms, epiphora, GO-Quality of Life Questionnaire (QoL), lagophthalmos, marginal reflex distance (MRD-1) index, eyelid symmetry within 1mm. The statistical analysis was designed to detect postoperative improvement in objective and subjective clinical features. Outcomes were analysed through Chi-squared test for dichotomous variables and through Wilcoxon-Mann-Whitney test for continuous variables. Results: Of the 111 patients, 42 underwent a bilateral procedure, while 69 a monolateral. Conjunctival symptoms were reported in 32% of cases before surgery and in 12.4% after FTABM (p < 0.001). Epiphora was complained by 29.6% of patients preoperatively and in 12.4% postoperatively (p < 0.001). Preoperative lagophthalmos was found in 12.4% (mean value of 0.34 ± 0.76 mm) of eyelids, and in 2.6% (mean value 0.05 ± 0.19 mm) eyelids (p = not significant) postoperatively. Pre-operative GO-QoL was 24.9 ± 4.4 mm; while post-operative GO-QoL was 35.3 ± 5.5 mm (p < 0.001). The MRD-1 varied from 10.12 ± 2.1 mm preoperatively, to 4.3 ± 0.6 mm (p < 0.001) after surgery. Asymmetric palpebral fissure was noted in 94 (84.7%) patients before surgery and in 7 (6.3%) after the procedure (p < 0.001). Conclusion: FTABM is an effective procedure to treat UER GO-related. The technique manages to prevent complications of UER and determine good aesthetics. Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . Level IV, therapeutic study. |
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| MeSH term(s) | Blepharoplasty/methods ; Eyelid Diseases/etiology ; Eyelids/surgery ; Graves Ophthalmopathy/surgery ; Humans ; Lacrimal Apparatus Diseases/complications ; Lacrimal Apparatus Diseases/surgery ; Quality of Life ; Retrospective Studies ; Treatment Outcome ; Vision Disorders | |||||
| Language | English | |||||
| Publishing date | 2022-02-07 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 532791-x | |||||
| ISSN | 1432-5241 ; 0364-216X | |||||
| ISSN (online) | 1432-5241 | |||||
| ISSN | 0364-216X | |||||
| DOI | 10.1007/s00266-022-02770-5 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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