A Vector Force Model of Upper Eyelid Position in the Setting of a Trabeculectomy Bleb

Ophthalmic Plastic and Reconstructive Surgery
Thomas J E ClarkErin M Shriver

Abstract

A vector force model for the determination of upper eyelid position in the setting of a trabeculectomy bleb is presented. The model is used to explain the clinical courses of 5 patients with bleb-induced upper eyelid malposition and the efficacy of modalities previously described for the treatment of bleb-induced upper eyelid retraction. The novel use of botulinum toxin in the treatment of bleb-induced eyelid retraction and unique surgical considerations in patients with trabeculectomy blebs undergoing upper eyelid surgery are discussed. A vector force analysis was conducted and a force diagram constructed. The clinical and surgical courses of 5 patients with trabeculectomy blebs and upper eyelid malposition were reviewed. The vector force model was applied to these cases and the previously described treatment modalities for bleb-induced upper eyelid retraction. Vector force analysis demonstrates that in the case of trabeculectomy bleb-induced upper eyelid retraction, the net force vector, which represents the sum of all the individual forces acting on the eyelid, has a positive vertical component resulting in superior displacement of the eyelid. In contrast, bleb-induced ptosis results when the net force vector has a negative ...Continue Reading

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Citations

Oct 31, 2016·Survey of Ophthalmology·Petrina Tan, Raman Malhotra
Mar 30, 2021·European Journal of Ophthalmology·Allisa J SongLilly H Wagner
Nov 24, 2021·European Journal of Ophthalmology·Teresa Salvá-PalomequeFrancisco J Muñoz-Negrete

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