Eye Dominance and Hering’s Law Effect on Bilateral Blepharotosis Repair

Abstract

Eye dominance and Hering's law dependence are postulated to influence eyelid position, and thus affect surgical outcomes following blepharoptosis surgery. Pseudoretraction of the contralateral eyelid, usually observed in the nondominant eye, is a well-recognized occurrence in the ophthalmic literature. In this article, these 2 phenomena were assessed preoperatively in blepharoptosis patients to evaluate their effect on postoperative outcomes. In this retrospective cohort study, postoperative eyelid position and rates of reoperation were investigated in 38 patients with bilateral involutional ptosis, who underwent bilateral ptosis repair. Institutional Review Board approval was obtained. In addition to the standard ptosis preoperative evaluation, patients were tested for Hering's law dependence and eye dominance. None of the patients included in the study had significant postoperative eyelid asymmetry or required reoperation. Eye dominance and Hering's law dependence did not affect the surgical outcomes of the patients included in this study who had bilateral ptosis repair performed. It was postulated that this may be due to the balancing of these 2 factors intraoperatively, thus negating their effect on eyelid position postoperatively.