Orbital Septum Attachment Sites on the Levator Aponeurosis in Asians and Whites

Purpose: To characterize the attachment site of the orbital septum on the levator aponeurosis and the anatomic level of the inferior end of the preaponeurotic fat pad, both in Asians and whites. Materials and Methods: Full-thickness sagittal sections of upper eyelids, fixed in 10% buffered formalin, were microscopically examined in 18 postmortem upper eyelids of 10 Asian cadavers (mean death age, 78 years; age range, 68-89 years) and 11 postmortem upper eyelids of 7 whites (mean death age, 88 years; age range, 78-101 years). We measured the distance from the superior tarsal border to the attachment site of the orbital septum on the levator aponeurosis based on the position of the distal end of the anterior layer of the levator aponeurosis. In addition, the position of the inferior end of the preaponeurotic fat pad was simultaneously measured from the superior tarsal border. Results: The average distance from the superior tarsal border to the distal end of the anterior layer of the levator aponeurosis was 4.44 mm in Asians and 3.71 mm in whites (p = 0.412). The average distance from the superior tarsal plate border to the preaponeurotic fat pad was 1.90 mm in Asians and 3.17 mm in whites (p = 0.173). Conclusions: The distance from the orbital septum attachment site on the levator aponeurosis to the superior tarsal border is similar in Asians and whites. However, there is some tendency, although not statistically significant, to a lower extension of the preaponeurotic fat pad in Asians.