Analysis of eyelid and eyebrow metrics in Iranian American adults

Background: Achieving patient satisfaction after oculofacial surgery requires sensitivity to ethnic anthropometric variation. While differences between the Caucasian and East Asian eyelid configurations are often discussed, there is a relative paucity of discussion related to characteristics of the Middle Eastern eyelid and periocular region. This study aims to understand differences between the eyelids and periocular region of patients of mixed Iranian extraction, versus those of mixed European descent. Methods: In this cross-sectional cohort study, external photographs were collected from a prospectively maintained database at an oculofacial plastic surgery practice. Ethnicity, age, gender, and photographic data were extracted from patient charts. Iranian-American patients were compared to Caucasian-American patients. From full-face photographs, brow position (pupil-to-brow, PTB), eyelid position (margin-to-reflex distance 1 and 2, MRD1 and MRD2), and tarsal platform show (TPS) were analyzed. Mixed effect ANOVA modeling was employed. Results: The Iranian-American eyelid complex was found to maintain a lower MRD1 (-0.34 mm, p < 0.01), higher MRD2 (+0.48 mm, p < 0.01), and longer TPS (+0.74 mm, p < 0.01) compared to Caucasian-American patients. Further, pupil-to-brow (PTB) distance was noted to be 1.46 mm higher (p < 0.01) in Iranian-Americans. Conclusion: Patients with Iranian-American ethnicity, compared to those of mixed European extraction, demonstrate distinctive eyelid anthropometric features. An understanding of these features may help to guide aesthetic surgical planning.