The concept and surgical technique of “Bright-eye surgery” in Asian is introduced in this paper.
From Jan 2006 to Oct 2012, external levator/Müller surgeries were performed in 1,075 patients (1952
eyes) who did not have functional complaint of eyelid ptosis, in an attempt to make their eyes more
bright-looking. The mean patient age was 31.6 (range from 16 to 64). During the first year of beginning
the procedure, revision surgeries were required in 48 patients (23.4%). Afterwards, revision rates
decreased to 7.1% with experience and technical refinement. The cause for the revision varied: more
precise correction of asymmetry, overcorrection or under-correction of the palpebral opening, with
the demand for getting more attractive exposure of iris-pupil complex. Overall, 98.4% of the patients
were satisfied with their outcomes of “Bright-eye surgery”, even though some of them underwent
second or third operations. Unlike practices and ideas of Caucasian upper eyelid surgery(mainly for
levator/Müller surgery), their Asian application needs different aesthetic concept and surgical
approach for patient satisfaction. Achieving favorable amount of iris-pupil exposure (i.e. 85 92% in
young lady) through posterior lamella surgery in Asians is the key to achieve this goal.