title: Intraoperative quantification using finger force for involutional blepharoptosis without postoperative lagophthalmos.
abstract: OBJECTIVE
  To report intraoperative quantification using finger force for involutional blepharoptosis, which helps in the prevention of postoperative lagophthalmos.
  
  
  METHODS
  We carried out levator resection on 20 involutional blepharoptic eyelids. Fissure height was examined intraoperatively to evaluate the extent of resection. If a patient presented more than 3 mm of lagophthalmos in voluntary eyelid closure but could fully open the eye, we forcibly closed the eyelid, using a finger, after voluntary eyelid closure. If more than 3 mm of lagophthalmos was still observed after forced eyelid closure, we corrected eyelid tension until lagophthalmos became less than 2 mm.
  
  
  RESULTS
  Six of the ten patients (20 eyelids) presented with full eyelid opening but more than 3 mm of lagophthalmos in voluntary eyelid closure. After the upper eyelids were forcibly lowered, all six eyelids showed less than 2 mm of lagophthalmos. There were no cases of lagophthalmos 1 month postoperatively.
  
  
  CONCLUSIONS
  Additional finger force makes precise quantification of blepharoptosis surgery possible and prevents postoperative lagophthalmos.
authors.affiliation: Department of Ophthalmology, Aichi Medical University, Aichi, Japan. cosme@d1.dion.ne.jp
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Kakizaki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Zako
authors.forename: Hidenori
authors.initials: H
authors.lastname: Mito
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Iwaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019882:Blepharoplasty; D001763:Blepharoptosis / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D005143:Eyelids / Q000503:physiopathology*; D005260:Female; D005385:Fingers; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies