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Orbital Aging Documented with Long-Term Photography: Senile Enophthalmos as a Cause of Upper Lid Ptosis
Bahman Guyuron MD
Donald Harvey MD
University Hospitals Case Medical Center
2014-03-15
Presenter: Donald (DJ) Harvey MD
Affidavit:
Director Name: Hooman Soltanian MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Purpose: The aim of this study was to observe the effects orbital aging over a prolonged period.
Methods: Twenty-one adult patients were followed for 11-24 years with medical quality facial photographs. The AP and lateral photographs were evaluated for orbital changes including enophthlamos and palpebral aperture. A panel of three plastic surgery residents evaluated the photographs and rated orbital changes. Patients with moderate to severe enophthalmos were identified and analyzed separately.
Results: The mean age at initial photography was 40yrs and at the time of second photography was 57 years. At the initial time four pts had no ptosis, twelve had mild ptosis, and five had moderate ptosis. At the second time point eight patients had mild ptosis, ten had moderate ptosis, and three had severe ptosis. Of the patient with mild to moderate ptosis at the second time point, all were found to have at least mild enophthalmos while two patients with mild ptosis, two patients with moderate ptosis, and one patient with severe ptosis had moderate to severe enophthalmos. When evaluating patients who had moderate to severe enophthalmos, they were found to have greater ptosis (p=0.02) and increased mean age.
Conclusion: This study demonstrates the significant development of enophthalmos as a result of periorbital aging in producing eyelid ptosis. One of the important elements of aging, which often goes unnoticed, is the globe position and eyelid ptosis. To create uniformity in rejuvenation one needs to focus on this part of aging more diligently.
