Ocular surface and the upper eyelid contour after surgical treatment of upper eyelid retraction in thyroid eye disease

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Abstract

BACKGROUND: Most of the thyroid eye disease (TED) patients have dry eye syndrome. Upper eyelid retraction (UER) is the most common TED symptom and one of dry eye causes. There are two groups of UER surgical treatment methods: transconjunctival and transcutaneous, which can influence on upper eyelid contour, tear film and ocular surface.

AIM: To evaluate the influence of different methods of UER surgery on upper eyelid contour and ocular surface.

MATERIALS AND METHODS: 12 patients (19 eyes) were included in the study. Visual acuity test, measurements of UER and palpebral fissure height, Shirmer 1 test, LIPCOF-test and tear break-up time test, Meibomian gland dysfunction staging, corneal and conjunctival fluorescein staining and determination of the ocular surface disease index (OSDI) were performed before surgery and 1 week, 1 and 3 months after. Patients were divided into two groups. Patients of group 1 had UER less than 4 mm and they underwent an upper tarsal muscle extirpation. Patients of group 2 had UER 4 mm and more and they underwent a recession of the levator palpebrae superioris muscle apouneurosis.

RESULTS: In all patients UER and the height of the palpebral fissure decreased 7 days after surgery and increased again after 3 months, and the dynamics of this change was more pronounced in group 2. There was one patient (both sides) with poor upper eyelid contour after surgery in both groups. BCVA and OSDI improved, while other parameters had a large scatter of data.

CONCLUSIONS: We have found that surgical treatment of UER caused by TED improves the contour of the eyelid, increases visual acuity and leads to a subjective improvement in the condition of the ocular surface.

About the authors

Liliia K. Anikina

I.P. Pavlov First Saint Petersburg State Medical University

Author for correspondence.
Email: lily-sai@yandex.ru
ORCID iD: 0000-0001-8794-0457
SPIN-code: 3359-4587

Postgraduate Student, Professor Yu.S. Astakhov Ophthalmology Department with Clinic

Russian Federation, Saint Petersburg

Sergey Yu. Astakhov

I.P. Pavlov First Saint Petersburg State Medical University

Email: astakhov73@mail.ru
ORCID iD: 0000-0003-0777-4861
SPIN-code: 7732-1150
Scopus Author ID: 56660518500

Dr. Sci. (Med.), Professor, Head, Professor Yu.S. Astakhov Department of Ophthalmology with Clinic

Russian Federation, Saint Petersburg

Vitaliy V. Potemkin

I.P. Pavlov First Saint Petersburg State Medical University; City Multidiscipline Hospital No. 2

Email: potem@inbox.ru
ORCID iD: 0000-0001-7807-9036
SPIN-code: 3132-9163

Cand. Sci. (Med.), Assistant Professor, Professor Yu.S. Astakhov Department of Ophthalmology with Clinic

Russian Federation, Saint Petersburg; Saint Petersburg

Shohida E. Babaeva

St. Petersburg State Pediatric Medical University

Email: babaevasho@gmail.com
ORCID iD: 0000-0003-1047-9230

Student

Russian Federation, Saint Petersburg

Serafima A. Kostygina

North-Western State Medical University named after I.I. Mechnikov

Email: kostyginaserafima@gmail.com
ORCID iD: 0000-0003-3415-6495

Student

Russian Federation, Saint Petersburg

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Supplementary files

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2. Fig. 1. Palpebral fissure height measurement

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3. Fig. 2. Distribution of thyroid diseases among patients

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4. Fig. 3. Patient with a good upper eyelid contour after surgical treatment (left eye) and postoperative scar

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5. Fig. 4. Patient with poor upper eyelid contour due to the residual “flare” phenomenon

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Copyright (c) 2022 Anikina L.K., Astakhov S.Y., Potemkin V.V., Babaeva S.E., Kostygina S.A.

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
 


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