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Effect of double-fold surgery on spontaneous resolution of Graves' upper eyelid retraction

Title
 Effect of double-fold surgery on spontaneous resolution of Graves' upper eyelid retraction
Authors
 Dong Kyu Kim; Moonjung Choi; Jin Sook Yoon
Issue Date
2015
Journal Title
 Canadian Journal of Ophthalmology
ISSN
 0008-4182
Citation
 Canadian Journal of Ophthalmology, Vol.50(1) : 49~53, 2015
Abstract
OBJECTIVE: To investigate the effect of previous incisional double-fold surgery on spontaneous resolution of eyelid retraction caused by Graves orbitopathy (GO) in Asian individuals. DESIGN: Retrospective review of medical records. PARTICIPANTS: Patients (N = 30; 39 eyes) with eyelid retraction associated with GO with symptom duration of less than 6 months. METHODS: Patients who visited the Ophthalmology Department of Severance Hospital, Yonsei University, between January 2010 and December 2011, followed up for more than 6 months and in a euthyroid state with antithyroid drug treatment were included. Patients treated with steroids or who underwent surgery during follow-up were excluded. Upper scleral show was measured as the distance between the central upper lid margin and limbus at initial presentation and after 6 months. Comparative analysis was performed between the 2 groups delineated by history (n = 12; 16 eyes), or lack thereof (n = 18; 23 eyes), of incisional double-fold surgery before onset of GO symptoms and signs. RESULTS: Patient demographics and initial upper scleral show were not significantly different between groups. In both groups, upper scleral show significantly decreased at 6 months of follow-up (p < 0.001 in both groups); however, improvement of upper scleral show was significantly reduced in patients who had undergone previous double-fold surgery (0.8 ± 0.5 mm) than in nonsurgical patients (1.8 ± 0.5 mm; p < 0.001). CONCLUSIONS: Graves eyelid retraction resolves spontaneously over time, albeit not completely. Previous double-fold surgery hinders the degree of spontaneous resolution, probably because of the fibrosis and cicatrization between the skin, the subcutaneous layer, and the levator complex.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/141489
DOI
10.1016/j.jcjo.2014.08.012
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Ophthalmology
Yonsei Authors
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Link
 http://www.sciencedirect.com/science/article/pii/S0008418214002920
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