title: Ocular surface area changes after double eyelidplasty.
abstract: BACKGROUND
  Double eyelidplasty is one of the most common cosmetic surgeries in Asia. Subjective enlargement of the ocular surface area (OSA) after double eyelidplasty was appreciated by patients. Objective measurement of the OSA provides a more scientific result. We introduce a relatively precise method, using iris as a scale combined with the digital photography and software calculation, to measure the OSA before and after double eyelidplasty.
  
  
  METHODS
  One hundred and nineteen patients (108 females and 11 males) were enrolled in this study. Ninety-two patients received minimally invasive double eyelidplasty without other procedures and 27 patients received medial epicanthoplasty with modified Z-plasty besides double eyelidplasty. Digital photographs of the operative eyes in all patients were obtained preoperatively and postoperatively. The image processing software we used was ImageJ (v1.43, National Institutes of Health, United States). Preoperative and postoperative OSAs were measured. The percentage of difference of the OSA between two eyes in same patient before and after the operation was calculated and compared.
  
  
  RESULTS
  The average increase of the OSA among 238 operative eyes was 12.5 ± 8.2%. Preoperative and postoperative OSA differences between two eyes in same patients were significantly decreased after surgery.
  
  
  CONCLUSIONS
  Digital photography using iris as a scale combined with software calculation is an easy and convenient method to measure the OSA; it provides quantitative information for both preoperative and postoperative evaluation. Our study revealed that double eyelidplasty not only increased OSA but also improved ocular asymmetry after surgery.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Ping-Yen
authors.initials: PY
authors.lastname: Tsai
authors.forename: Yi-Chia
authors.initials: YC
authors.lastname: Wu
authors.forename: Ching-Hung
authors.initials: CH
authors.lastname: Lai
authors.forename: Shu-Hung
authors.initials: SH
authors.lastname: Huang
authors.forename: Ya-Wei
authors.initials: YW
authors.lastname: Lai
authors.forename: Chung-Sheng
authors.initials: CS
authors.lastname: Lai
mesh_terms: D000328:Adult; D000869:Anterior Eye Segment / Q000033:anatomy & histology*; D044466:Asian People; D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000208:ethnology* / Q000601:surgery; D015331:Cohort Studies; D005143:Eyelids / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010781:Photography; D012189:Retrospective Studies; D013536:Suture Techniques; D013624:Taiwan; D016896:Treatment Outcome; D055815:Young Adult