Blepharotomy Versus Levator Recession With Adjustable Sutures for Correction of Upper Eyelid Retraction in Thyroid Eye Disease.

Autor:	Ueland HO; Department of Ophthalmology, Haukeland University Hospital, Bergen, Norway., Halsøy K; Department of Ophthalmology, Haukeland University Hospital, Bergen, Norway., Rødahl E; Department of Ophthalmology, Haukeland University Hospital, Bergen, Norway.; Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Jazyk:	angličtina
Zdroj:	Ophthalmic plastic and reconstructive surgery [Ophthalmic Plast Reconstr Surg] 2024 Sep-Oct 01; Vol. 40 (5), pp. 516-522. Date of Electronic Publication: 2024 Apr 15.
DOI:	10.1097/IOP.0000000000002632
Abstrakt:	Purpose: To compare outcome, complications and surgical time of blepharotomy versus levator recession with adjustable sutures (LRWAS) for correction of upper eyelid retraction in thyroid eye disease. Methods: In the period 2019-2023, we performed a prospective randomized comparative study between blepharotomy and LRWAS. We examined patients, recorded time consumption, and obtained photographs preoperatively, 1 day, 1 week, 3 months, and 6 months after surgery. Outcome was categorized according to Mourits and Sasim`s classification from 1999 (perfect-acceptable-unacceptable). Results: A total of 30 patients (25 women) with a median (range) age of 51.5 (34-74) years at surgery were included. A significant different ( p < 0.01) median operation time was found between blepharotomy (41.5 (17-105) minutes) and LRWAS (68 (35-101) minutes). Median time from operation to last examination was 6 (6-18) months. Fifteen patients (24 eyelids) were operated with blepharotomy and 15 patients (25 eyelids) with LRWAS. Preoperative median margin reflex distance 1 was 6.5 (5-8) mm, and at final visit, median margin reflex distance 1 was 3.5 (3-4) mm after blepharotomy and 3.5 (2-5.5) mm after LRWAS. Reoperation was performed in 11 eyelids, 10 due to overcorrection and 1 because of a residual retraction. Significantly more eyelids needed reoperation after LRWAS (n = 9) compared with blepharotomy (n = 2). At final examination, a perfect or acceptable result was found in 14 (93%) patients after both procedures. Significantly shorter total duration of all visits was observed after treatment with blepharotomy (50 (35-70) minutes) compared with LRWAS (65 (40-115) minutes). Wound dehiscence occurred in 1 patient after blepharotomy, and 1 postoperative infection was observed after LRWAS. Conclusion: We demonstrate equally high success rates after blepharotomy and LRWAS for correcting upper eyelid retraction in thyroid eye disease, but blepharotomy is less time-consuming and implies fewer reoperations. Competing Interests: The authors have no conflicts of interest to disclose. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.)
Databáze:	MEDLINE
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