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Abstract：
BACKGROUND: Subclinical ptosis is prevalent in Asian patients presenting for aesthetic upper blepharoplasty. To achieve predictable and satisfactory results in these patients, addressing the ptosis component is critical. In this paper, we present a precision levator advancement technique that enabled us to predictably incorporate the levator advancement into our upper blepharoplasty to deliver more predictable results in these patients.
METHODS: Asian patients with normal or near normal margin to reflex distance 1 (MRD 1 of ≥ 3.5 mm) and symptoms and signs of straining of the frontalis with eyelid opening were diagnosed with subclinical upper eyelid ptosis and included in this prospective study. The advancement required was estimated pre-operatively using a formula that we developed. Our surgical technique is presented in detail here, and our long-term results were analysed.
RESULTS: From December 2019 to August 2022, 97 patients were included in this study. Sixty-five patients were primary cases and 32 were revision cases. The mean follow-up was 15 months. Of the 192 eyelids analysed, our formula was able to correctly identify the required fixation location in 69% of eyelids. In majority of the eyelids (94%), the correct location of fixation location within +/- 1 mm of the estimated location. All patients (100%) were satisfied with their long-term results. Our revision rate was 3%.
CONCLUSIONS: Incorporating a precisely done levator advancement into the upper blepharoplasty in patients with subclinical ptosis is critical for optimizing the aesthetic and functional outcomes. This approach has enabled us to perform this procedure greater predictably in this group of patients.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
METHODS: Asian patients with normal or near normal margin to reflex distance 1 (MRD 1 of ≥ 3.5 mm) and symptoms and signs of straining of the frontalis with eyelid opening were diagnosed with subclinical upper eyelid ptosis and included in this prospective study. The advancement required was estimated pre-operatively using a formula that we developed. Our surgical technique is presented in detail here, and our long-term results were analysed.
RESULTS: From December 2019 to August 2022, 97 patients were included in this study. Sixty-five patients were primary cases and 32 were revision cases. The mean follow-up was 15 months. Of the 192 eyelids analysed, our formula was able to correctly identify the required fixation location in 69% of eyelids. In majority of the eyelids (94%), the correct location of fixation location within +/- 1 mm of the estimated location. All patients (100%) were satisfied with their long-term results. Our revision rate was 3%.
CONCLUSIONS: Incorporating a precisely done levator advancement into the upper blepharoplasty in patients with subclinical ptosis is critical for optimizing the aesthetic and functional outcomes. This approach has enabled us to perform this procedure greater predictably in this group of patients.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
摘要：
背景：亚裔患者表现为美学上眼睑成形术。为了在这些患者中获得可预测和令人满意的结果，解决眼睑组件是至关重要的。在本文中,我们提出了一种精确的提上肌前移技术,该技术使我们能够可预测地将提上肌前移纳入我们的上眼睑成形术中,从而为这些患者提供更可预测的结果.
方法：亚裔患者的边缘至反射距离1正常或接近正常（MRD1≥3.5mm），并伴有眼睑张开的额肌拉伤的症状和体征被诊断为亚临床上眼睑下垂，并包括在这项前瞻性研究中。术前使用我们开发的公式估算所需的进展。我们的手术技术在这里详细介绍，并对我们的长期结果进行了分析。
结果：从2019年12月到2022年8月，97名患者被纳入本研究。65例患者为原发病例，32例为翻修病例。平均随访15个月。在分析的192个眼睑中，我们的公式能够正确识别69％的眼睑所需的固定位置。大部分眼睑（94%）在估计位置的+/-1mm内的固定位置的正确位置。所有患者（100％）对他们的长期结果感到满意。我们的修订率为3%。
结论：在亚临床上下垂患者的上睑成形术中，将精确完成的提上提肌前移对于优化美学和功能结局至关重要。这种方法使我们能够在该组患者中更可预测地执行该程序。
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
方法：亚裔患者的边缘至反射距离1正常或接近正常（MRD1≥3.5mm），并伴有眼睑张开的额肌拉伤的症状和体征被诊断为亚临床上眼睑下垂，并包括在这项前瞻性研究中。术前使用我们开发的公式估算所需的进展。我们的手术技术在这里详细介绍，并对我们的长期结果进行了分析。
结果：从2019年12月到2022年8月，97名患者被纳入本研究。65例患者为原发病例，32例为翻修病例。平均随访15个月。在分析的192个眼睑中，我们的公式能够正确识别69％的眼睑所需的固定位置。大部分眼睑（94%）在估计位置的+/-1mm内的固定位置的正确位置。所有患者（100％）对他们的长期结果感到满意。我们的修订率为3%。
结论：在亚临床上下垂患者的上睑成形术中，将精确完成的提上提肌前移对于优化美学和功能结局至关重要。这种方法使我们能够在该组患者中更可预测地执行该程序。
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
