Nonsurgical management of upper eyelid margin asymmetry using hyaluronic acid gel filler

Ronald Mancini, Nicole M. Khadavi, Robert Alan Goldberg

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Purpose: To evaluate the efficacy of hyaluronic acid gel fillers as a nonsurgical alternative for the management of upper eyelid margin asymmetry in cases of relative retraction. Methods: This is a retrospective study of 8 patients with upper eyelid margin asymmetry relating to relative upper eyelid retraction treated with hyaluronic acid gel injection to affect upper eyelid lowering. Digital photographs were used to quantitatively assess outcomes by comparing pretreatment and posttreatment differences between marginal reflex distance (MRD1) in the right and left eyelids. Image J was used for photographic analysis, and Student paired t test was performed. Results: Eight patients (2 male; mean age, 50.9 years; range, 30-69 years) were injected with hylauronic acid gel in the upper eyelid. The etiology of upper eyelid margin asymmetry included Graves eyelid retraction (n = 3), asymmetry following reconstructive surgery (n = 1) and aesthetic surgery (n = 1), contralateral Horner syndrome (n = 1), Bell palsy (n = 1), and contralateral involutional ptosis (n = 1). The average volume injected in the upper eyelid was 0.2 ml (range, 0.1-0.4 ml). One of 8 patients was injected bilaterally. Average follow-up was 5.7 months (range, 2-12 months). Two of 8 patients requested repeat injection within a 6-month period for undercorrection. No overcorrections were noted, and no patient requested reversal with hyaluronidase. There was a statistically significant improvement in symmetry with mean pretreatment MRD1 difference of 1.53 mm (range, 0.78-3.36 mm) and mean posttreatment MRD1 difference of 0.70 mm (range, 0.02-2.03 mm), p = 0.007. At 4 to 8 months' follow-up, 8 of 8 demonstrated persistent improvement in asymmetry with statistically significant reduction in MRD1 difference when compared with pretreatment with average follow-up MRD1 difference of 0.74 mm (range, 0.11-1.65 mm), p = 0.018. Conclusion: This pilot study suggests that upper eyelid injection with hylauronic acid gel filler may be an effective nonsurgical alternative to improve upper eyelid margin asymmetry in cases of relative upper eyelid retraction.

Original languageEnglish (US)
Pages (from-to)1-3
Number of pages3
JournalOphthalmic Plastic and Reconstructive Surgery
Volume27
Issue number1
DOIs
StatePublished - Jan 2011

Fingerprint

Eyelids
Hyaluronic Acid
Gels
Injections
Reconstructive Surgical Procedures
Horner Syndrome
Bell Palsy
Acids
Hyaluronoglucosaminidase
Plastic Surgery
Reflex
Retrospective Studies
Students

ASJC Scopus subject areas

  • Ophthalmology
  • Surgery

Cite this

Nonsurgical management of upper eyelid margin asymmetry using hyaluronic acid gel filler. / Mancini, Ronald; Khadavi, Nicole M.; Goldberg, Robert Alan.

In: Ophthalmic Plastic and Reconstructive Surgery, Vol. 27, No. 1, 01.2011, p. 1-3.

Research output: Contribution to journalArticle

@article{4c2eb2f1b6784d169280a58dcd3b01d2,
title = "Nonsurgical management of upper eyelid margin asymmetry using hyaluronic acid gel filler",
abstract = "Purpose: To evaluate the efficacy of hyaluronic acid gel fillers as a nonsurgical alternative for the management of upper eyelid margin asymmetry in cases of relative retraction. Methods: This is a retrospective study of 8 patients with upper eyelid margin asymmetry relating to relative upper eyelid retraction treated with hyaluronic acid gel injection to affect upper eyelid lowering. Digital photographs were used to quantitatively assess outcomes by comparing pretreatment and posttreatment differences between marginal reflex distance (MRD1) in the right and left eyelids. Image J was used for photographic analysis, and Student paired t test was performed. Results: Eight patients (2 male; mean age, 50.9 years; range, 30-69 years) were injected with hylauronic acid gel in the upper eyelid. The etiology of upper eyelid margin asymmetry included Graves eyelid retraction (n = 3), asymmetry following reconstructive surgery (n = 1) and aesthetic surgery (n = 1), contralateral Horner syndrome (n = 1), Bell palsy (n = 1), and contralateral involutional ptosis (n = 1). The average volume injected in the upper eyelid was 0.2 ml (range, 0.1-0.4 ml). One of 8 patients was injected bilaterally. Average follow-up was 5.7 months (range, 2-12 months). Two of 8 patients requested repeat injection within a 6-month period for undercorrection. No overcorrections were noted, and no patient requested reversal with hyaluronidase. There was a statistically significant improvement in symmetry with mean pretreatment MRD1 difference of 1.53 mm (range, 0.78-3.36 mm) and mean posttreatment MRD1 difference of 0.70 mm (range, 0.02-2.03 mm), p = 0.007. At 4 to 8 months' follow-up, 8 of 8 demonstrated persistent improvement in asymmetry with statistically significant reduction in MRD1 difference when compared with pretreatment with average follow-up MRD1 difference of 0.74 mm (range, 0.11-1.65 mm), p = 0.018. Conclusion: This pilot study suggests that upper eyelid injection with hylauronic acid gel filler may be an effective nonsurgical alternative to improve upper eyelid margin asymmetry in cases of relative upper eyelid retraction.",
author = "Ronald Mancini and Khadavi, {Nicole M.} and Goldberg, {Robert Alan}",
year = "2011",
month = "1",
doi = "10.1097/IOP.0b013e3181c2a16d",
language = "English (US)",
volume = "27",
pages = "1--3",
journal = "Ophthalmic Plastic and Reconstructive Surgery",
issn = "0740-9303",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Nonsurgical management of upper eyelid margin asymmetry using hyaluronic acid gel filler

AU - Mancini, Ronald

AU - Khadavi, Nicole M.

AU - Goldberg, Robert Alan

PY - 2011/1

Y1 - 2011/1

N2 - Purpose: To evaluate the efficacy of hyaluronic acid gel fillers as a nonsurgical alternative for the management of upper eyelid margin asymmetry in cases of relative retraction. Methods: This is a retrospective study of 8 patients with upper eyelid margin asymmetry relating to relative upper eyelid retraction treated with hyaluronic acid gel injection to affect upper eyelid lowering. Digital photographs were used to quantitatively assess outcomes by comparing pretreatment and posttreatment differences between marginal reflex distance (MRD1) in the right and left eyelids. Image J was used for photographic analysis, and Student paired t test was performed. Results: Eight patients (2 male; mean age, 50.9 years; range, 30-69 years) were injected with hylauronic acid gel in the upper eyelid. The etiology of upper eyelid margin asymmetry included Graves eyelid retraction (n = 3), asymmetry following reconstructive surgery (n = 1) and aesthetic surgery (n = 1), contralateral Horner syndrome (n = 1), Bell palsy (n = 1), and contralateral involutional ptosis (n = 1). The average volume injected in the upper eyelid was 0.2 ml (range, 0.1-0.4 ml). One of 8 patients was injected bilaterally. Average follow-up was 5.7 months (range, 2-12 months). Two of 8 patients requested repeat injection within a 6-month period for undercorrection. No overcorrections were noted, and no patient requested reversal with hyaluronidase. There was a statistically significant improvement in symmetry with mean pretreatment MRD1 difference of 1.53 mm (range, 0.78-3.36 mm) and mean posttreatment MRD1 difference of 0.70 mm (range, 0.02-2.03 mm), p = 0.007. At 4 to 8 months' follow-up, 8 of 8 demonstrated persistent improvement in asymmetry with statistically significant reduction in MRD1 difference when compared with pretreatment with average follow-up MRD1 difference of 0.74 mm (range, 0.11-1.65 mm), p = 0.018. Conclusion: This pilot study suggests that upper eyelid injection with hylauronic acid gel filler may be an effective nonsurgical alternative to improve upper eyelid margin asymmetry in cases of relative upper eyelid retraction.

AB - Purpose: To evaluate the efficacy of hyaluronic acid gel fillers as a nonsurgical alternative for the management of upper eyelid margin asymmetry in cases of relative retraction. Methods: This is a retrospective study of 8 patients with upper eyelid margin asymmetry relating to relative upper eyelid retraction treated with hyaluronic acid gel injection to affect upper eyelid lowering. Digital photographs were used to quantitatively assess outcomes by comparing pretreatment and posttreatment differences between marginal reflex distance (MRD1) in the right and left eyelids. Image J was used for photographic analysis, and Student paired t test was performed. Results: Eight patients (2 male; mean age, 50.9 years; range, 30-69 years) were injected with hylauronic acid gel in the upper eyelid. The etiology of upper eyelid margin asymmetry included Graves eyelid retraction (n = 3), asymmetry following reconstructive surgery (n = 1) and aesthetic surgery (n = 1), contralateral Horner syndrome (n = 1), Bell palsy (n = 1), and contralateral involutional ptosis (n = 1). The average volume injected in the upper eyelid was 0.2 ml (range, 0.1-0.4 ml). One of 8 patients was injected bilaterally. Average follow-up was 5.7 months (range, 2-12 months). Two of 8 patients requested repeat injection within a 6-month period for undercorrection. No overcorrections were noted, and no patient requested reversal with hyaluronidase. There was a statistically significant improvement in symmetry with mean pretreatment MRD1 difference of 1.53 mm (range, 0.78-3.36 mm) and mean posttreatment MRD1 difference of 0.70 mm (range, 0.02-2.03 mm), p = 0.007. At 4 to 8 months' follow-up, 8 of 8 demonstrated persistent improvement in asymmetry with statistically significant reduction in MRD1 difference when compared with pretreatment with average follow-up MRD1 difference of 0.74 mm (range, 0.11-1.65 mm), p = 0.018. Conclusion: This pilot study suggests that upper eyelid injection with hylauronic acid gel filler may be an effective nonsurgical alternative to improve upper eyelid margin asymmetry in cases of relative upper eyelid retraction.

UR - http://www.scopus.com/inward/record.url?scp=78751650070&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78751650070&partnerID=8YFLogxK

U2 - 10.1097/IOP.0b013e3181c2a16d

DO - 10.1097/IOP.0b013e3181c2a16d

M3 - Article

C2 - 20551854

AN - SCOPUS:78751650070

VL - 27

SP - 1

EP - 3

JO - Ophthalmic Plastic and Reconstructive Surgery

JF - Ophthalmic Plastic and Reconstructive Surgery

SN - 0740-9303

IS - 1

ER -