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

Abstract

Introduction: 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. Methods: 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. Results: 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). Conclusions: 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.