OBJECTIVE: The Kufner modified Le Fort III osteotomy (LFIII) can be used to address midface deficiency, which is often accompanied by excessive scleral exposure. The purpose of this project is to analyze the changes in scleral exposure after a LFIII. METHODS: Thirteen patients with midface hypoplasia were treated with LFIII. Scleral surface area (SSA) was determined by pixel count and the distance from the inferior eyelid margin to the center of the pupil (MED) was measured pre- and postoperatively. Intraclass correlation coefficients were calculated to assess measurement reliability and repeated measures analysis of variance (ANOVA) were determined to assess systematic difference among the replicates. RESULTS: The interquartile range for change in SSA ranged from -31% to -7%, median 20% (P = .002) and the interquartile range for change in MED ranged from -21% to -12%, median -18% (P = .0002). CONCLUSIONS: SSA and MED can be reliably determined using the aforementioned method. The LFIII decreases scleral exposure.
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