title: Variations in the degree of epiblepharon with changes in position and induction of general anesthesia.
abstract: BACKGROUND
  To investigate the changes of epiblepharon by evaluating the severity of epiblepharon before and after induction of general anesthesia.
  
  
  METHODS
  Sixty-three pediatric patients (126 eyes) underwent surgery for epiblepharon between April 2008 and September 2008 (35 females, 28 males; average age: 4.74 years). The severity of epiblepharon in each eye was scored according to skin-fold height (scored 1-4) and area of ciliocorneal touch (scored 1-3) while the patient was in upright and supine positions before induction of general anesthesia and in supine position after induction of anesthesia.
  
  
  RESULTS
  The severity of epiblepharon was significantly reduced by a positional change to supine position and induction of general anesthesia. Skin-fold height scores decreased when patients were moved from upright (estimated mean ± standard error [SE]; 2.98 ± 0.08) to supine position (2.63 ± 0.09) (P < 0.001) prior to induction of anesthesia, and decreased further after induction of general anesthesia (2.12 ± 0.08) (P < 0.001). Ciliocorneal touch scores also decreased after patients were moved to supine position and after induction of general anesthesia (upright: 2.17 ± 0.05; supine: 1.95 ± 0.06; general anesthesia: 1.64 ± 0.07, P < 0.001).
  
  
  CONCLUSIONS
  Our study demonstrates that positional changes and general anesthesia using muscle relaxants affect the degree of epiblepharon. Surgeons should be aware of these variations for operative planning of epiblepharon.
authors.affiliation: Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: Soolienah
authors.initials: S
authors.lastname: Rhiu
authors.forename: Jin Sook
authors.initials: JS
authors.lastname: Yoon
authors.forename: Su Yan
authors.initials: SY
authors.lastname: Zhao
authors.forename: Sang Yeul
authors.initials: SY
authors.lastname: Lee
mesh_terms: D000768:Anesthesia, General; D001279:Atracurium / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005141:Eyelid Diseases / Q000151:congenital* / Q000209:etiology / Q000503:physiopathology; D005143:Eyelids / Q000002:abnormalities / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage; D009801:Oculomotor Muscles / Q000503:physiopathology*; D011187:Posture / Q000502:physiology*; D012885:Skinfold Thickness
chemical_list: D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium