Redistribution of Gaze Patterns in Facial Localized Scleroderma Following Autologous Fat Transfer: An Eye-Tracking Study.

BACKGROUND

The study aimed to use eye-tracking technology objectively quantifying changes in visual attention patterns in observers viewing faces of patients with facial localized scleroderma (LoS) before and after autologous fat transplantation (AFT).

METHODS

In this retrospective observational study, preoperative and postoperative standardized photographs of 30 patients with facial localized scleroderma (LoS) were presented to 50 observers. Gaze data were recorded using an eye tracker. Fixation proportions were analyzed for all affected regions and for specific facial subunits.

RESULTS

A total of 30,266 fixation points were recorded. Postoperatively, the fixation proportion on the affected hemiface significantly decreased by 4.92% (p<0.05), with a concomitant increase in fixations redirected toward the unaffected side. Furthermore, an increase of 2.39% (p<0.05) in fixation proportion was observed in the central T-zone (periorbital and nasal regions). Subunit analysis revealed reductions in fixations on the affected cheek (16.12% to 10.39%, p<0.05) and forehead (17.18% to 13.23%, p<0.05). Stratified analysis showed that severe dermal atrophy and severe dyspigmentation were associated with less postoperative fixation reduction, whereas fixation reduction did not differ significantly by subcutaneous atrophy severity.

CONCLUSION

AFT alters observers' visual attention by reducing fixations on the affected facial areas and redirecting gaze toward the unaffected side and the central T-zone. This shift suggests a partial redistribution of social-perceptual gaze patterns toward a more typical facial viewing pattern.

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