J Korean Ophthalmol Soc.  2021 Aug;62(8):1015-1021. 10.3341/jkos.2021.62.8.1015.

The Effect of Levator Recession for Upper Eyelid Retraction in Patients with Thyroid-associated Ophthalmopathy

• Oh JY
• Lee JK

• KMID: 2519320
• DOI: http://doi.org/10.3341/jkos.2021.62.8.1015

Abstract

Purpose
We analyzed factors that affect the outcome of levator recession surgery for upper eyelid retraction in patients with thyroid-associated ophthalmopathy.
Methods
Retrospective analysis was performed based on the medical records of 24 patients with thyroid-associated ophthalmopathy who underwent upper eyelid levator recession surgery between February 10, 2010, and September 18, 2018. The margin to reflex distance (MRD), length and area of the upper and lower eyelids were measured and compared with the eyelid analysis software before and after 6 months of surgery on medical records. In addition, factors affecting the difference in MRD1 before and after surgery were examined by multivariate linear regression analysis.
Results
Twenty-four patients were included in the study. The MRD1 decreased significantly from 5.12 ± 1.26 mm before surgery to 3.48 ± 1.08 mm at 6 months after surgery (p < 0.001). All upper eyelid measurements, i.e., UEL (p < 0.001), UMA (p < 0.001), UCA (p = 0.004), and ULA (p < 0.001), were significantly decreased after surgery, while none of the lower eyelid measurements showed significant changes. Multivariate logistic regression analysis indicated that lower preoperative MRD1 was associated with the success of the surgery (odds ratio, 0.31; 95% confidence interval, 0.09-1.01).
Conclusions
Levator recession surgery is an efficient surgical method that can correct the upper eyelid retraction associated with thyroid-associated ophthalmopathy.

Keyword

Levator recession; Thyroid-associated ophthalmopathy; Upper eyelid retraction