Characterization of the Upper Tarsal Plate Growth in Children: Implication in Pediatric Eyelid Surgery.

Abstract

To measure the height, length, and area of the upper tarsal plate in Korean children between 6 months and 13 years of age and analyze growth of the tarsal plate. Children who underwent lower epiblepharon correction surgery and congenital nasolacrimal duct obstruction were included. Under general anesthesia, the upper eyelid was everted and a photograph was taken with a reference ruler using a digital camera. Tarsal plate central height, upper border length, lower border length, and area were measured using Image J software. Objectives were classified into 4 groups according to age. Mean analysis and comparison between groups were performed using the SPSS program. One hundred two tarsal plates in 51 patients were measured. Mean central tarsal height was 6.92 ± 1.09 in the 0 to 3 years old group, 7.25 ± 0.81 in the 4 to 6 years old group, 7.64 ± 0.71 in the 7 to 9 years old group, and 8.11 ± 0.46 in the 10 to 13 years old group. The height and area of the tarsal plate gradually increased with age (P = 0.001), but the lower length of the 0 to 3 years old group differed from the other groups and showed abrupt increase between the 0 to 3 years and 4 to 6 years old groups (P < 0.001 by the Kruskall-Wallis test and post-hoc analysis). There was a statistically significant difference between the central tarsal height of 0 to 6 years old groups and that of the 10 to 13 years old groups (P = 0.001). The height and length of the tarsal plate increase in children with age and it reached adult size between the ages of 10 and 13 years. In the 0 to 3 years old group, tarsal height and length are shorter than that of the 10 to 13 years old group and this difference should be considered when performing upper lid surgery.