Aesthetic problems of eye protrusion in Orientals

Abstract 

The typical characteristics of Oriental faces are less prominent supraorbital ridges, a flat and broad nose, and thick, bulky upper eyelids. These characteristics make the eye appear protruded even when they are within the normal range or on the borderline of the exophthalmometric data. Prior to correction of the protruding eye, the patient’s medical and psychological status are investigated. The volume of the bony orbit is estimated using 3-D CT scan data and exophthalmometry before and after the operation. The surgical correction is planned to decompress the orbital contents with preservation of the visual axis. The lateral orbital wall is expanded without change of facial width. The medial wall and orbital floor are outfractured with preservation of continuity of the maxillary and ethmoid bone and sinus mucosa to prevent herniation of the orbital contents and disturbance of extraocular muscle dysfunction. Removal of the retrobulbar fat is mainly from the upper half of the orbit. In the past three years, orbital decompression has been performed in eight patients (12 eyes) for aesthetic reasons. The exophthalmometric data ranged from 17.5 mm to 19.5 mm, with an average of 18.3 mm before operation, this changed 2.0 to 7.0 mm with an average of 3.54 mm after operation. The postoperative complications were two cases of subconjunctival hemorrhage and one case of temporary diplopia. After follow-up of 14 months (4–38 months), there were no cosmetic or functional problems.