The distribution of elastic fibers in the Asian upper eyelid skin

Purpose: To analyze the distribution and characteristics of upper eyelid skin elastic fibers in different areas of skin thickness and in relation to the eyelid crease. Methods: We used 12 postmortem eyelids (6 right, 6 left) of 10 Asian cadavers (mean age: 77.1 years at death), fixed in 10% buffered formalin. Full-thickness sagittal sections of the upper eyelids were dehydrated, embedded in paraffin, and cut in 7-μm-thick sections. The sliced sections were stained with elastica van Gieson. Results: The upper eyelid skin was divided in 2 areas; the thinner and thicker areas. The average distance from the eyelid margin to the border between the 2 areas was 17.8 mm (range, 12.8-24.0 mm). Ten eyelids showed a small amount of elastic fibers in the thinner skin area, and 2 eyelids were rich in elastic fibers in the same area. The volume of elastic fibers multiplied in the thicker skin area. The elastic fibers in the eyelid margin area were fine and nonfragmented, whereas in other areas they were thicker and more fragmented. A part below the skin creases showed the same concentration of elastic fibers to other areas of the upper eyelid skin. Conclusions: Most upper eyelids demonstrated a small amount of elastic fibers in the thinner skin area and a larger amount in the thicker area. The eyelid margin elastic fibers had a normal morphology, whereas in other areas they were more disintegrated, thicker, and fragmented. The eyelid creases and the elastic fiber concentration were unrelated.