HENDERSONS RELIEF OF EYELID RETRACTION REVISITED

The purpose of the study was to identify those patients ,vith thyroid eye disease and upper eyelid retraction who would benefit from Henders on's procedure (myotomy of Muller's superior tarsal muscle with graded division of levator aponeurotic fibres on the anterior tarsal plate), The clinical records of patients attending the Thyroid Clinic of Moor fields Hospital who had undergone Henderson's procedures were reviewed , Twenty-two patients (19 women, 3 men) had Henderson's procedures at age 35-69 years (mean 49.9), with a mean follow-up of 4.55 years, Elev en patients had bilateral upper eyelid surgery, 11 unilateral (33 eyel ids), The pre-operative vertical palpebral apertures ranged from 11 to 19 mm (mean 13.95); the post-operative vertical palpebral apertures r anged from 8 to 15 mm (mean 11.45), a mean reduction of 2.5 mm (p < 0. 001), Eight of twenty-two patients (36%) had further eyelid surgery an d 3 of 22 (14%) had further surgery recommended because of persistent upper eyelid retraction, abnormal eyelid contour (lateral hare) and as ymmetry, It is concluded that Henderson's procedure should be reserved for those patients with minor degrees of almost symmetrical upper eye lid retraction who do not have abnormalities of their eyelid contour.