{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T04:54:37Z","timestamp":1781499277621,"version":"3.54.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background\/objectives<\/jats:title>\n                    <jats:p>Periocular plastic surgery lacks standardized, objective tools for preoperative planning and postoperative evaluation, currently relying on subjective assessment and manual measurements. This study aims to validate VisionMetric Suite, an artificial intelligence-based automated periocular measurement tool, and compare its performance with manual methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We developed VisionMetric Suite based on the dlib library and shape estimation algorithms. The tool automatically measures 60 quantitative periocular parameters. The software was evaluated on 226 frontal facial photographs for recognition rate, processing speed, and user satisfaction. Thirty images were randomly selected to assess the agreement between automated and manual measurements and the repeatability of the AI tool using ICC and Bland-Altman analysis. Clinical utility was demonstrated through a case of left congenital ptosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The software achieved a recognition rate of 94.7% and an average processing time of 2.8 \u00b1 0.4 s per image. User satisfaction among 10 physicians averaged 4.3\/5.0. Agreement between automated and manual measurements showed a mean ICC of 0.94 (95% CI: 0.91\u20130.97), and repeatability of repeated AI measurements showed a mean ICC of 0.96 (95% CI: 0.92\u20130.98). Bland\u2013Altman analysis confirmed these findings, and a representative clinical case illustrated the software's practical utility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This preliminary single-center validation study suggests that VisionMetric Suite can serve as a rapid, objective periocular measurement tool with good agreement compared to manual methods, representing an initial step toward automated assessment in ophthalmic plastic surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1855884","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T04:26:16Z","timestamp":1781497576000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["VisionMetric Suite for periocular measurement in ophthalmic plastic surgery: a preliminary single-center validation study"],"prefix":"10.3389","volume":"13","author":[{"given":"Tengfei","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Burns and Plastic Surgery, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunke","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Dermatology, The Second People's Hospital of Guiyang","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Burns and Plastic Surgery, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingyi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Burns and Plastic Surgery, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingying","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Burns and Plastic Surgery, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengru","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Burns and Plastic Surgery, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"B1","unstructured":"ISAPS International Survey on Aesthetic\/Cosmetic Procedures Performed in 2024\n          \n          2025"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e569","DOI":"10.1097\/SCS.0000000000001304","article-title":"Accuracy of marginal reflex distance measurements in eyelid surgery","volume":"26","author":"Nemet","year":"2015","journal-title":"J Craniofac Surg."},{"key":"B3","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1136\/bjo.85.1.99","article-title":"Repeatability and reproducibility of upper eyelid measurements","volume":"85","author":"Boboridis","year":"2001","journal-title":"Br J Ophthalmol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1691","DOI":"10.3390\/jcm14051691","article-title":"The usefulness of AI-based cornea exposure rate (CER) analysis utilizing the Anigma view system in evaluating ptosis surgery outcomes","volume":"14","author":"Park","year":"2025","journal-title":"J Clin Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1016\/j.jaapos.2021.05.020","article-title":"Photographic assessment of eyelid position using a simple measurement tool paired with cell phone photography in a pediatric population","volume":"25","author":"Prakalapakorn","year":"2021","journal-title":"J AAPOS"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.bjps.2022.02.073","article-title":"Applications of three-dimensional surgical planning in facial feminization surgery: a systematic review","volume":"75","author":"Escand\u00f3n","year":"2022","journal-title":"JPRAS."},{"key":"B7","doi-asserted-by":"publisher","first-page":"2426","DOI":"10.1097\/SCS.0000000000009644","article-title":"Three-dimensional digital technology: a powerful assistant for the reconstruction of complex craniofacial deformities","volume":"34","author":"Huang","year":"2023","journal-title":"J Craniofac Surg."},{"key":"B8","doi-asserted-by":"publisher","first-page":"100887","DOI":"10.1016\/j.xops.2025.100887","article-title":"Development and validation of a semiautomated tool for measuring periorbital distances","volume":"5","author":"Peterson","year":"2025","journal-title":"Ophthalmol Sci."},{"key":"B9","doi-asserted-by":"publisher","first-page":"e141","DOI":"10.1016\/j.bjps.2012.01.010","article-title":"Ocular surface area changes after double eyelidplasty","volume":"65","author":"Tsai","year":"2012","journal-title":"J Plast Reconstr Aesthet Surg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1109\/CVPR.2013.75","article-title":"Supervised descent method and its applications to face alignment","author":"Xiong","year":"2013","journal-title":"Proceedings of the IEEE conference on computer vision and pattern recognition, Portland, OR"},{"key":"B11","doi-asserted-by":"publisher","first-page":"108195","DOI":"10.1016\/j.neunet.2025.108195","article-title":"Interpretable facial landmark detection by multi-expert collaborative uncertainty-aware deep networks","volume":"194","author":"Wan","year":"2026","journal-title":"Neural Netw."},{"key":"B12","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1001\/archfaci.2012.111","article-title":"Toward a universal, automated facial measurement tool in facial reanimation","volume":"14","author":"Hadlock","year":"2012","journal-title":"Arch Facial Plast Surg."},{"key":"B13","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1001\/jamafacial.2018.0030","article-title":"A machine learning approach for automated facial measurements in facial palsy","volume":"20","author":"Guarin","year":"2018","journal-title":"JAMA Facial Plast Surg."},{"key":"B14","doi-asserted-by":"publisher","first-page":"100518","DOI":"10.1016\/j.xops.2024.100518","article-title":"Automatic measurement and comparison of normal eyelid contour by age and gender using image-based deep learning","volume":"4","author":"Shao","year":"2024","journal-title":"Ophthalmol Sci."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1202","DOI":"10.1038\/s41598-024-51838-6","article-title":"Development of a neural network-based automated eyelid measurement system","volume":"14","author":"Nam","year":"2024","journal-title":"Sci Rep."},{"key":"B16","doi-asserted-by":"publisher","first-page":"2278","DOI":"10.1080\/07853890.2021.2009127","article-title":"Deep learning-based image analysis for automated measurement of eyelid morphology before and after blepharoptosis surgery","volume":"53","author":"Lou","year":"2021","journal-title":"Ann Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1867","DOI":"10.1109\/CVPR.2014.241","article-title":"One millisecond face alignment with an ensemble of regression trees","author":"Kazemi","year":"2014","journal-title":"Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition (CVPR), Columbus, OH"},{"key":"B18","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1097\/01.ico.0000148312.01805.53","article-title":"White-to-white corneal diameter: normal values in healthy humans obtained with the Orbscan II topography system","volume":"24","author":"R\u00fcfer","year":"2005","journal-title":"Cornea."},{"key":"B19","doi-asserted-by":"publisher","first-page":"e84976","DOI":"10.7759\/cureus.84976","article-title":"Establishment and reliability of an automatic measurement method of pectus excavatum indices using a deep learning model","volume":"17","author":"Deng","year":"2025","journal-title":"Cureus."},{"key":"B20","doi-asserted-by":"publisher","first-page":"2825","DOI":"10.1007\/s00266-022-02878-8","article-title":"Aesthetic changes of brow-eyelid continuum after correction of moderate\u2013severe blepharoptosis with conjoint fascial sheath suspension","volume":"46","author":"Fan","year":"2022","journal-title":"Aesth Plast Surg."},{"key":"B21","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1016\/j.ajodo.2021.03.017","article-title":"Machine learning in orthodontics: automated facial analysis of vertical dimension for increased precision and efficiency","volume":"161","author":"Rousseau","year":"2022","journal-title":"Am J Orthod Dentofacial Orthop."},{"key":"B22","doi-asserted-by":"publisher","first-page":"5201","DOI":"10.3390\/s23115201","article-title":"Hybrid Domain consistency constraints-based deep neural network for facial expression recognition","volume":"23","author":"Zhu","year":"2023","journal-title":"Sensors."},{"key":"B23","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A guideline of selecting and reporting intraclass correlation coefficients for reliability research","volume":"15","author":"Koo","year":"2016","journal-title":"J Chiropr Med."},{"key":"B24","doi-asserted-by":"publisher","first-page":"e222112","DOI":"10.1590\/2177-6709.27.4.e222112.oar","article-title":"Comparison between cephalometric measurements using digital manual and web-based artificial intelligence cephalometric tracing software","volume":"27","author":"\u00c7oban","year":"2022","journal-title":"Dental Press J Orthod."},{"key":"B25","doi-asserted-by":"publisher","first-page":"6463","DOI":"10.1038\/s41598-024-56956-9","article-title":"Fully automated landmarking and facial segmentation on 3D photographs","volume":"14","author":"Berends","year":"2024","journal-title":"Sci Rep."},{"key":"B26","doi-asserted-by":"publisher","first-page":"13914","DOI":"10.1038\/s41598-025-93975-6","article-title":"Deep learning based adaptive and automatic measurement of palpebral margin in eyelid morphology","volume":"15","author":"Ahemaiti","year":"2025","journal-title":"Sci Rep."},{"key":"B27","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.joco.2015.09.001","article-title":"White-to-white corneal diameter distribution in an adult population","volume":"27","author":"Hashemi","year":"2015","journal-title":"J Curr Ophthalmol."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1855884\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T04:26:18Z","timestamp":1781497578000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1855884\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":27,"alternative-id":["10.3389\/fmed.2026.1855884"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1855884","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,15]]},"article-number":"1855884"}}