Conjoint fascial sheath suspension for early correction of severe blepharoptosis after double-eyelid blepharoplasty

Wang, H.; Liu, L.; Wang, Z.-J.

doi:10.1016/j.bjoms.2020.04.044

Cited by 6 publications

(5 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Anteriorly, superficial and deep extensions of CFS continued approximately 2 mm to the superiorconjunctival fornix and then 2–3 mm distally along and beneath the palpebral and bulbar conjunctiva [ 16 ]. It was first applied to correct ptosis in 2002, and since then, this technique of CFS suspension has become increasingly popular for severe blepharoptosis [ 17 , 18 ]. The CFS+LM complex suspension operation uses not only the dynamic strengthening principle of levator muscle shortening, but also the static suspension of tough CFS.…”

Section: Resultsmentioning

confidence: 99%

A new technique to prevent conjunctival prolapse in Asian patients for correcting severe blepharoptosis

Xi,

He,

Yang

2024

BMC Ophthalmol

View full text Add to dashboard Cite

Background In Asian patients with severe ptosis,the use of conjoint fascia sheath (CFS) suspension or levator aponeurosis fascia complex shortening surgery can correct the ptosis. During these surgery, a significant amount of levator aponeurosis fascia shortening is performed, which often leads to serious complications such as conjunctival prolapse.This study compares two surgical approaches for correcting severe blepharoptosis:Conjoint fascial sheath (CFS) + levator aponeurosis and muller’s muscle complex (LM complex) suspension and conjoint fascial sheath (CFS) + LM complex+conjunctival suspension.The postoperative efficacy and the incidence of complications such as conjunctival prolapse are investigated for both procedures. Methods This study retrospectively analyzed 70 patients (77eyes) with severe blepharoptosis from January 2019 to December 2021. The patients were divided into the experimental group (34 cases, 38 eyes) and the control group (36 cases, 39 eyes). The experimental group was treated with CFS+LM complex + conjunctival suspension, and the control group was treated with CFS+LM complex suspension.The curative effect of blepharoptosis, the incidence of complications such as conjunctival prolapse and patient satisfaction were compared between the two different surgical methods. Results There was no significant difference in the correction effective rate between the experimental group (84.21%) and the control group (82.05%) (P > 0.05). There was no significant difference in the total incidence of complications between the experimental group (23.68%) and the control group (38.46%) (P > 0.05), but in the complication of conjunctival prolapse, the incidence of conjunctival prolapse in the experimental group was significantly lower than that in the control group. The difference was statistically significant (P < 0.05). In the survey of patient satisfaction rate, the satisfaction rate of the experimental group was significantly higher than that of the control group,which was statistically significant (P < 0.05). Conclusions Compared to CFS+LM complex suspension surgery, the CFS+LM complex + conjunctival suspension has a definite effect in preventing postoperative conjunctival prolapse .The procedure has a high feasibility, good corrective effect, and improves patient satisfaction after surgery.

show abstract

Section: Resultsmentioning

confidence: 99%

A new technique to prevent conjunctival prolapse in Asian patients for correcting severe blepharoptosis

Xi,

He,

Yang

2024

BMC Ophthalmol

View full text Add to dashboard Cite

show abstract

“…The main reason for these is that the direction of the traction force of the frontal muscle during the correction of ptosis is vertical upward, which changes the direction of the physiological force of the upper eyelids (6,22). Over the past decade, CFS suspension surgery has attracted considerable attention (23,24). The safety, therapeutic and cosmetic effects of CFS suspension surgery have been reported to be significantly superior compared with those of traditional frontalis muscle suspension (4,(25)(26).…”

Section: Discussionmentioning

confidence: 99%

Elastin expression in the conjoint fascial sheath and levator palpebrae superioris muscle of children with unilateral severe congenital ptosis with different muscle strengths

Jia,

Liu,

Shi

et al. 2024

Exp Ther Med

View full text Add to dashboard Cite

Elastin expression in the conjoint facial sheath (CFS) of patients of different ages with severe ptosis has been extensively studied, but its expression in the CFS of pediatric patients with severe ptosis with different muscle strengths remains poorly understood. The aim of the present study was to investigate the expression of elastin in the CFS and levator palpebrae superioris muscle (LM) of children with severe congenital ptosis with different LM strengths. In total, 20 pediatric patients with unilateral severe congenital ptosis (20 eyes) were included, who underwent CFS + LM complex suspension surgery from June 2020 to February 2022. Among these patients, the LM strength was 0-1 mm in 10 patients and 2-3 mm in the other 10 patients. Excess CFS and LM tissue samples were obtained from the patients during surgery, before the protein expression levels of elastin in the specimens were measured by western blotting. During the 6-month postoperative follow-up period, the good correction rate, the degree of incomplete eyelid closure and the incidence of complications were observed. Western blotting results showed that, compared with that in the 0-1 mm group, elastin expression was not significantly different in the CFS, whereas it was significantly increased (P=0.021) in the LM of the 2-3 mm group. In addition, elastin expression in the CFS was markedly higher compared with that in the LM in both groups (in the 0-1 mm group, P=0.005; in the 2-3 mm group, P=0.009). Additionally, the curative effect evaluation revealed that the good correction rates in the 0-1 and 2-3 mm groups were 90 and 100%, respectively. In total, 3 patients experienced conjunctival prolapse during the follow-up period, including 2 patients in the 0-1 mm group and 1 patient in the 2-3 mm group, but there were no other complications. To conclude, elastin expression in the CFS was found to be higher compared with that in the LM of children with severe congenital ptosis. Although elastin expression in the LM was positively associated with LM strength, its expression in the CFS displayed no clear association with LM function. Therefore, these observations suggested that CFS + LM complex suspension surgery is viable to correct severe congenital ptosis in pediatric patients.

show abstract

“…In the past decade, CFS has attracted a great deal of attention as a cure for congenital blepharoptosis [ 4 , 12 ]. Much earlier, in 1805, Tenon discovered and described the existence of the CFS, believing it to be the tendinous fascia of the superior rectus muscle; functionally, this connective structure was reported to assist the function of the rectus muscle and promote the movement of the upper eyelid [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…In 2008, Hwang proposed that this structure is a piece of fibrous connective tissue formed by the fusion and proliferation of the LM and superior rectus fascia, naming it the conjoint fascial sheath, or CFS [ 19 ]. In recent years, many studies have applied CFS suspension or CFS + LM complex suspension to correct severe congenital blepharoptosis; these procedures have been found to have many advantages [ 4 , 12 , 20 ], such as a lack of obvious separation of the eyelid from the eyeball, a lack of severe postoperative discomfort, a natural double eyelid, swift postoperative recovery and intact eyebrow and forehead tissues. The mechanism of CFS + LM suspension is to suture the CFS + LM complex to the tarsal plate through a double eyelid incision, which lifts the upper eyelid.…”

Section: Discussionmentioning

confidence: 99%

Research on the expression of elastin in the conjoint fascial sheath for the correction of severe unilateral congenital blepharoptosis

et al. 2022

View full text Add to dashboard Cite

Background To investigate the expression of elastin in the conjoint facial sheath (CFS) in patients with severe unilateral congenital blepharoptosis in different age groups. Methods Twenty-seven cases of severe unilateral congenital blepharoptosis (27 eyes) were treated with CFS + LM complex suspension from January 2020 to July 2020. Within that sample, 9 patients were over 18 years old, 9 patients were 13 to 17 years old and 9 patients were 5 to 12 years old. CFS and LM specimens were collected during CFS + LM complex suspension surgery. In the CFS specimens, the elastic fibers were observed by Victoria Blue staining. The elastin expression levels of the three groups of specimens were determined and analyzed by immunofluorescent staining and Western blotting. Results Victoria Blue staining showed that elastic fibers were abundant in CFS tissue. Moreover, immunofluorescent staining showed strong positive expression of elastin in the CFS and LM. Furthermore, in the child group, the Western blot results demonstrated that the expression of elastin was higher in the CFS than in the LM (P < 0.05). Additionally, the expression of elastin was significantly higher in the CFS of children than in that of adults or adolescents (P < 0.001). Conclusions The CFS and LM are rich in elastic fibers and elastin, although elastin expression in the CFS decreases with age. Thus, it is feasible to apply CFS + LM complex suspension to cure severe unilateral congenital blepharoptosis.

show abstract

Conjoint fascial sheath suspension for early correction of severe blepharoptosis after double-eyelid blepharoplasty

Cited by 6 publications

References 6 publications

A new technique to prevent conjunctival prolapse in Asian patients for correcting severe blepharoptosis

A new technique to prevent conjunctival prolapse in Asian patients for correcting severe blepharoptosis

Elastin expression in the conjoint fascial sheath and levator palpebrae superioris muscle of children with unilateral severe congenital ptosis with different muscle strengths

Research on the expression of elastin in the conjoint fascial sheath for the correction of severe unilateral congenital blepharoptosis

Contact Info

Product

Resources

About