Asian upper eyelids are unique in terms of eyelid crease, tarsal plate show (TPS) and epicanthal fold (EF). Literature shows 7 articles all of which studied on cadavers and assessed eyelid crease and central skin thickness. There is, however, no study on histological characteristics of medial upper eyelid skin between Asian vs. non-Asian subjects. The aim is to compare medial upper eyelid thickness and elastic fiber density and morphology of Asian Iranian vs. Non-Asian Iranian age matched group. This is the first study comparing medial upper eyelid of Asian vs. non-Asian subjects.

In a prospective comparative study, 5 right upper eyelid skin of 5 Asian-Iranian non-smokers, class III Fitzpatrik skin type females (18-40 years old) were compared to their age matched counterparts (Non-Asian.Medial upper eyelid skin (medial limbus to medial canthus) was preoperatively marked and intraoperatively removed and sent for histopathological examination by a masked observer. A masked pathologist recorded skin thickness as well as elastic fiber density and morphology (10 specimens). Primary outcome measure was to compare histopathological characteristics of two groups. Secondary outcome measure was to compare 3 zones (inferior, middle, superior) of medial eyelid skin within each group in order to observe if different parts of medial upper eyelid are showing different histopathological characteristics.

Two groups were not significantly different regarding to epidermal (0.1 < P < 0.9), Dermal (0.3 < P < 0.8), and total skin thickness (0.3 < P < 1) as well as elastic fiber density (0.1 < P < 0.7) and morphology (P=1). Similarly, Histopathological characteristics were not significantly different between 3 zones of medial upper eyelid at each group (0.4 < P < 1).

No significant histologically difference was found between Asian Iranian versus Non-Asian Iranian medial Upper Eyelids regarding the thickness, elastic fiber density and morphology.