Eye Tracking Gauges Response to Mohs Defect Reconstruction

By Reuters Staff

November 12, 2019

NEW YORK (Reuters Health) - Eye-tracking technology may give objective insight into how casual onlookers perceive the facial features of patients following Mohs reconstructive surgery, according to an observational study.

This knowledge "is critical because patient self-perception, psychosocial health, and quality of life are markedly influenced by how others perceive their face and facial disfigurements," Dr. Lisa E. Ishii and colleagues at Johns Hopkins School of Medicine, in Baltimore, Maryland, note in JAMA Facial Plastic Surgery, online October 31.

The researchers hypothesized that Mohs defects would alter the normal pattern of facial perception and distract observers' attention from critical facial features such as the eyes. Eye-tracking could help quantify the response.

To investigate further, the team used an eye-tracking system to record how 82 casual observers directed attention at photographs of 32 patients with Mohs facial defects of varying sizes and locations before and after reconstruction. Also included were 16 control faces with no facial defects.

The observers viewed the control faces in a similar and consistent fashion. Most attention (65%) was paid to the central triangle involving the eyes, nose and mouth. The eyes were the most important feature within the central triangle, occupying a mean of 60% of attention time within the triangle and 39% of total attention time.

The presence of Mohs defects was associated with significant alterations in the pattern of facial attention. Greater attention was paid to them and less to the eyes. The difference increased with defect size and location.

Attention ranged from less than a second (729 ms) for small peripheral defects to more than three and a half seconds (3,693 ms) for large central defects.

However, "Reconstructive surgery was associated with improved gaze deviations for all faces and with normalized attention directed to the eyes for all faces except for those with large central defects," the researchers report.

These data, they add, "are important to patients who want to know how reconstructive surgery could change the way people look at their face." They also may help to enable "outcomes prediction based on facial defect size and location before reconstruction."

Dr. Ishii did not respond to requests for comments.

SOURCE: https://bit.ly/36LgzaA

JAMA Facial Plast Surg 2019.