Quantification of palpebral fissure shape in severe congenital blepharoptosis.

PURPOSE: To measure palpebral fissure morphology in patients with severe congenital blepharoptosis.
METHODS: The palpebral fissure shape of 20 patients (30 eyes) with severe congenital blepharoptosis (levator excursion < or = 4 mm) was quantified with digital image processing in a cross-sectional design. Several variables related to the morphology of the palpebral fissure were measured: (a) upper and lower eyelid curvature, (b) palpebral fissure angle, and (c) position of the upper maximum and lower minimum eyelid contour.
RESULTS: Patients with severe congenital blepharoptosis often show a moderate degree of antimongoloid palpebral fissure orientation and eyelid drooping that is greater temporally than nasally.
CONCLUSIONS: Contour adjustment in severe congenital blepharoptosis surgery is better when it is not centered on the midline, but rather has a slight lateral displacement.