Correction of Severe Blepharoptosis

Deenstra, Wilco; Melis, Paris; Kon, Moshe; Werker, Paul M. N.

doi:10.1097/00000637-199604000-00004

Cited by 30 publications

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“…When there is severe blepharoptosis, the frontalis sling operation with various materials, such as catgut, collagen, fascia lata, Prolene, silicone, stainless steel, or tendons, is the most common procedure chosen. However, several disadvantages were noted, including exposure of alloplastic materials and migration into the eyelid [18], high infection rates of silicone implants [19], and visible scar and herniation of the vastus lateralis muscle at the donor site [20]. …”

Section: Discussionmentioning

confidence: 99%

A Dynamic Technique for the Treatment of Severe or Recurrent Blepharoptosis: Frontalis-Orbicularis Oculi Muscle Flap Shortening

Lai

Chang²,

Lai³

et al. 2009

Ophthalmologica

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Background: Severe or recurrent blepharoptosis remains a great challenge to most plastic surgeons. A variety of techniques have been developed according to the function of the levator palpebrae superioris and frontalis muscles. In this study, the frontalis-orbicularis oculi (FOO) muscle flap is designed as an entity to treat severe or recurrent blepharoptosis with satisfactory results. Methods: Between January 1997 and July 2007, FOO muscle flap shortening was applied to correct severe or recurrent blepharoptosis in 29 patients (38 eyelids), aged from 3 to 77 years. There were 11 males and 18 females, with bilateral ptosis in 9 patients. The follow-up period ranged from 10 to 52 months. Results: Twenty-four patients (82%) had good results, with the degree of ptosis less than 2 mm. The remaining 5 patients had fair results, and received readjustment in 2 cases. Conclusion: In our study, fresh cadaver dissection revealed that the frontalis muscle is connected and interdigitated very closely with the orbicularis oculi muscle. Based on the anatomic study and literature review, we suggest that the FOO muscle flap shortening is a good alternative to treat severe or recurrent blepharoptosis.

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Section: Discussionmentioning

confidence: 99%

A Dynamic Technique for the Treatment of Severe or Recurrent Blepharoptosis: Frontalis-Orbicularis Oculi Muscle Flap Shortening

Lai

Chang²,

Lai³

et al. 2009

Ophthalmologica

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“…Human sclera, banked fascia lata, expanded poly(tetrafluoroethylene) (ePTFE or Gore-Tex), braided polyester, monofilaments, and silicone rod have also been used. [15][16][17][18][19][20][21][22][23][24][25][26][27][28] Important results include eyelid height, skin crease depth, and eyelid contour. The aim of this study was to determine the long term results and complications of Mersilene mesh in frontalis suspension surgery for the correction of poor levator function ptosis.…”

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confidence: 99%

Functional results and complications of Mersilene mesh use for frontalis suspension ptosis surgery

Mehta

2004

British Journal of Ophthalmology

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“…Autogenous fascia lata is the most appropriate material for the use in frontalis suspension, but there are insufficient amounts of this material in children younger than 3 years of age. Donor fascia lata provides a reasonable alternative that decreases the attendant morbidity and reduces the complexity of the procedure [16,26,27] . When fascia lata is not available, whether autogenous or donor, synthetic materials can be used.…”

Section: Resultsmentioning

confidence: 99%

Outcome of Y to V Medial Canthoplasty With Medial Canthal Tendon Plication for the Correction of Blepharophimosis- Ptosis-Epicanthus Inversus Syndrome

Elbakary

2015

International Journal of Ophthalmic Research

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CONCLUSION:The two stages management using simple procedures as Y to V medial canthoplasty with MCT plication followed by frontalis suspension or maximum levator resection yielded satisfactory results in the correction of complicated deformity as BPES. INTRODUCTIONBlepharophimosis-ptosis-epicanthus inversus syndrome (BPES) is an uncommon congenital disorder characterized by a narrowed horizontal palpebral aperture, ptosis, epicanthus inversus, and telecanthus. It typically has bilateral features, although not always symmetrical [1,2] . This syndrome is inherited as an autosomal disease, but also can be manifested as a result of new genetic mutations and sporadic cases without family history of the disease can occur. Several studies confirmed the presence of mutations such as deletion or translocation of the FOXL2 gene, which maps to chromosome 3q21-24 [3,4] . Surgical treatment for BPES is one of the most complex in the field of eyelid surgery due to the presence of multiple deformities. Many surgical techniques have been described to address the epicanthus inversus and accompanying telecanthus including Y to V flaps, the Mustarde technique, the 5-flap technique, medial canthal tendon shortening or plication, and transnasal wiring, and none of them is free from criticism [5][6][7][8][9] . Some authors recommended that medial canthoplasty should be performed first followed by ptosis correction, while others recommended one stage. Therefore, there is no unanimous consensus on BPES correction with respect to either MATERIALS AND METHODS:Prospective interventional case series which included 15 cases of BPES. Two stages management was used in all cases. The first stage was Y to V medial canthoplasty with MCT plication. 3 months later, ptosis was corrected by bilateral frontalis suspension or maximum levator resection in the more ptotic eyelid in patients with asymmetric ptosis. Data regarding margin reflex distance 1 (MRD1), horizontal palpebral fissure length (HPFL), inner intercanthal distance (IICD), and the ratio of IICD to HPFL were recorded before and after surgery and were statistically analyzed. Post operative IICD/HPFL ratio of 1.5 or less was considered successful outcome. RESULTS: The mean age of patients was 3.7±0.8 years. According to the postoperative IICD/HPFL, 12 patients (80%) had successful outcome. The preoperative IICD had a mean of 37.6±1.5 mm, which was reduced post operative to a mean of 33.0±2.3 mm. The HPFL improved from preoperative mean 21±1.2 mm to postoperative mean 24.2±1.4 mm. The mean preoperative IICD/HPFL ratio was 1.8±0.2 which was reduced post operative to a mean of 1.37±0.2. The MRD1 improved from preoperative mean of 1±0.4 mm to 3.6±0.3 mm post operative. The main complication recorded was undercorrection which was observed in 3 patients (20%).

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Correction of Severe Blepharoptosis

Cited by 30 publications

References 0 publications

A Dynamic Technique for the Treatment of Severe or Recurrent Blepharoptosis: Frontalis-Orbicularis Oculi Muscle Flap Shortening

A Dynamic Technique for the Treatment of Severe or Recurrent Blepharoptosis: Frontalis-Orbicularis Oculi Muscle Flap Shortening

Functional results and complications of Mersilene mesh use for frontalis suspension ptosis surgery

Outcome of Y to V Medial Canthoplasty With Medial Canthal Tendon Plication for the Correction of Blepharophimosis- Ptosis-Epicanthus Inversus Syndrome

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