Hard palate mucosa graft height in the correction of lower eyelid retraction
What:
Paper Presentation | Présentation d'article
Part of:
When:
3:51 PM, Friday 1 Jun 2018
(6 minutes)
Where:
Metro Toronto Convention Centre (South Building)
- Room 714 A
How:
Authors: Michel Belliveau, Sonul Mehta, Rahul Sharma, James Oestreicher
Author Disclosure Block: M. Belliveau: None. S. Mehta: None. R. Sharma: None. J. Oestreicher: None.
Abstract Body:
Purpose: To evaluate the relationship between graft height and lower eyelid elevation
Study Design: Retrospective interventional case series
Methods: Institutional research ethics board approval was obtained. Charts were identified over a 4-year period using billing records. The relationship between the change in the amount of inferior scleral show following hard palate grafting and graft height was assessed. Minimum of 6 months post-operative follow-up was required. Grafts were categorized into 3 groups; small [less than 5 mm, n=14, mean (SD) 3.9 (0.3) mm, median 4 mm], medium [5mm to less than 7 mm, n=21, mean (SD) 5.6 (0.5) mm, median 6 mm], large [7 mm or greater, n=12, mean (SD) 7.9 (0.7) mm, median 8mm].
Results: Forty-seven lower eyelids in 25 patients were included (13 thyroid eye disease, 7 post-blepharoplasty, 5 other). Mean (SD) follow up was 10.7 (5.2) months. The mean (SD) pre-operative scleral show was 1.4 (0.7) mm. The mean (SD) post-operative scleral show was 0.2 (0.3) mm. The mean (SD) amount of scleral show treated by the 3 sizes of grafts were; small 0.9 (0.6) mm, medium 1.4 (0.5) mm, and large 2.0 (0.7) mm. With a mean graft size of 5.7 mm, the overall ratio of graft size per mm improvement in scleral show was 4.6 (or 0.22 mm scleral show improvement per mm graft). This relationship held within each of the graft size groups; small and medium, 4.6 mm graft per mm improvement in scleral show (or 0.22 mm scleral show improvement per mm graft); large, 4.7 mm graft per mm improvement in scleral show (or 0.21 mm scleral show improvement per mm graft). Correlation was moderately positive (Spearman’s rho =0.464, p=0.001).
Conclusions: Graft height requirements for effective elevation are approximately double than what is commonly recommended (4.6:1 compared with 2-3:1).
Author Disclosure Block: M. Belliveau: None. S. Mehta: None. R. Sharma: None. J. Oestreicher: None.
Abstract Body:
Purpose: To evaluate the relationship between graft height and lower eyelid elevation
Study Design: Retrospective interventional case series
Methods: Institutional research ethics board approval was obtained. Charts were identified over a 4-year period using billing records. The relationship between the change in the amount of inferior scleral show following hard palate grafting and graft height was assessed. Minimum of 6 months post-operative follow-up was required. Grafts were categorized into 3 groups; small [less than 5 mm, n=14, mean (SD) 3.9 (0.3) mm, median 4 mm], medium [5mm to less than 7 mm, n=21, mean (SD) 5.6 (0.5) mm, median 6 mm], large [7 mm or greater, n=12, mean (SD) 7.9 (0.7) mm, median 8mm].
Results: Forty-seven lower eyelids in 25 patients were included (13 thyroid eye disease, 7 post-blepharoplasty, 5 other). Mean (SD) follow up was 10.7 (5.2) months. The mean (SD) pre-operative scleral show was 1.4 (0.7) mm. The mean (SD) post-operative scleral show was 0.2 (0.3) mm. The mean (SD) amount of scleral show treated by the 3 sizes of grafts were; small 0.9 (0.6) mm, medium 1.4 (0.5) mm, and large 2.0 (0.7) mm. With a mean graft size of 5.7 mm, the overall ratio of graft size per mm improvement in scleral show was 4.6 (or 0.22 mm scleral show improvement per mm graft). This relationship held within each of the graft size groups; small and medium, 4.6 mm graft per mm improvement in scleral show (or 0.22 mm scleral show improvement per mm graft); large, 4.7 mm graft per mm improvement in scleral show (or 0.21 mm scleral show improvement per mm graft). Correlation was moderately positive (Spearman’s rho =0.464, p=0.001).
Conclusions: Graft height requirements for effective elevation are approximately double than what is commonly recommended (4.6:1 compared with 2-3:1).
