LAUSR

Estimating the volume of fat to be resected during lower lid blepharoplasty can be challenging. While the excess fat is clearly visible in the upright position, it retracts into the orbital cavity when the patient is in decubitus. Several tools have been developed to predict the volume required for adequate outcomes and to reduce the risk of complications. Among these, 3D photography, in addition to being noninvasive, radiation-free, portable and relatively inexpensive, can be used to make simulations. To assess the level of agreement between Vectra H1 camera simulations and the outcome of lower eyelid blepharoplasties with volume removal based on these simulations. Preoperatively, a 3D camera and simulation software (Vectra H1, Canfield Imaging Systems) was used to estimate the fat pad volume to be resected from the lower eyelids in a sample of 35 patients (female n = 34) aged 55 years on average. Following the procedure, the patients were photographed at 1, 3 and 6 months and the outcome was compared to the simulation. The agreement between the simulated volume and the intraoperative volume was high. While the difference between the postoperative volume and the simulated volume decreased over time, at 6 months the actual volume was still 0.30 mL (right eye) and 0.24 mL (left eye) larger than the simulated volume. A systematic and significant difference was found between the simulation volume and the postoperative volume. The low level of agreement observed suggests that the accuracy of the tested software is insufficient for reliable simulations. This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.