Histological findings of levator muscle in unilateral congenital ptosis in different age groups

Quaranta‐Leoni, Francesco M.; Secondi, Roberto; Quaranta‐Leoni, Flavia; Nardoni, Stefano

doi:10.1111/aos.14284

Cited by 6 publications

(3 citation statements)

References 12 publications

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“…Histopathological findings revealed fat infiltration, fibrosis, and decreased numbers of muscle fibers in the levator muscle in cases of congenital ptosis. 18 Moreover, there was an inverse correlation between the number of muscle fibers and the severity of ptosis, 19 which was consistent with a clinical phenomenon in which the levator muscle was gauzy and fragile in cases of severe congenital ptosis and was prone to collapse when dissociating it from the conjunctiva. The traditional levator resection technique involves separating the levator muscle completely, which will inevitably collapse the muscle.…”

Section: Discussionsupporting

confidence: 67%

Modified Maximal Levator Palpebrae Superioris Shortening in Correcting Congenital Severe Ptosis in Children

Liu

et al. 2021

Ann Plast Surg

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Objective This study aims to evaluate the clinical effect of modified maximal levator palpebrae superioris shortening method for severe congenital ptosis. Methods A retrospective case series was performed including 66 eyes from 62 patients who underwent modified maximal levator palpebrae superioris shortening surgery to treat severe congenital ptosis between February 2015 and November 2018. Preoperative and postoperative margin reflex distance 1 and levator muscle function were recorded. The surgical results were graded as good, satisfied, and poor for functional and cosmetic improvement of the eyelids, and the incidence of complications was also documented. Results The mean patient age at the time of surgery was 4.6 ± 1.8 years (2–9 years), and the mean follow-up time was 36.3 ± 14.1 (12–55 months). A mean significant improvement in margin reflex distance 1 and levator function after operation was noted (P < 0.01). The eyelid height and symmetry were satisfied in 59 patients, with success rate of 95.2%. For the patients in the levator function (≤2 mm) group, the success rate was 87.5%. Moreover, the levator function (≤2 mm) group had a higher rate of poor results than levator function (2–4 mm) group (12.5% vs 2.2%). Overcorrection (6.5%) and eyelid fold deformity (11.3%) were the most frequent postoperative complications. Conclusion Modified maximal levator palpebrae superioris shortening was effective and endurable in the treatment of severe congenital ptosis with poor levator function, including in patients whose levator function was less than 2 mm.

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Section: Discussionsupporting

confidence: 67%

Modified Maximal Levator Palpebrae Superioris Shortening in Correcting Congenital Severe Ptosis in Children

Liu

et al. 2021

Ann Plast Surg

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“…In recent, the histological study of the CFS [ 1 ] and LM [ 21 ] has received much attention among ophthalmologists. In our study, the histological results showed that the CFS is a fibrous connective tissue membrane.…”

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

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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.

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“…Congenital ptosis, especially moderate and severe ptosis, affects children’s visual function and aesthetics, and also interferes with their normal quality of life ( 11 , 12 ). Hypoplasia of the levator palpebral is the main pathogenesis in congenital cases, and may also be associated with dysgenesis or insufficiency of the central and peripheral nerves which innervate the levator palpebral ( 13 ). Early surgical correction to restore the visual function of children and improve the quality of life of children is the main treatment strategy at present, and the surgical method used has become a hot topic of clinical research.…”

Section: Discussionmentioning

confidence: 99%

Application of e-PTFE Frontalis Suspension in the Treatment of Congenital Ptosis in Children

Zhang

Liu

et al. 2022

Front. Surg.

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PurposeAnalysis of the value of expanded polytetrafluoroethylene (e-PTFE) frontalis suspension applied to children with congenital ptosis.MethodsEighty clinical cases of children with congenital ptosis from October 2019 to October 2021 were randomly selected from our hospital. All children were divided into the observation group (n = 44) treated with e-PTFE frontalis suspension and the control group (n = 36) treated with frontalis flap suspension according to the treatment procedure. Comparison of eyelid condition [palpebral fissure height, margin reflex distance (MRD), eyelid closure time], ocular surface status [corneal fluorescein staining (CFS) score, tear film breakup time (TBUT), surgical eye lacrimal river height (LRH), sehirmer test I (STI)], frontal muscle strength of affected side, cosmetic results and complications in both groups at 1, 6 and 12 months postoperative follow-up.ResultsAt 1, 6 and 12 months after surgery, there was no significant difference in terms of palpebral fissure height and MRD between both groups (p > 0.05); After surgery, the eyelid closure time was shorter in the observation group than in the control group (p < 0.05). At 1, 6 and 12 months after surgery, the CFS scores were lower in the observation group than in the control group (p < 0.05); At 6 and 12 months after surgery, the TBUT was longer and the surgical eye LRH was higher in the observation group than in the control group (p < 0.05); At 1, 6, and 12 months after surgery, there was no significant difference in STI between both groups (p < 0.05). At 1, 6 and 12 months after surgery, the frontal muscle strength of affected side was higher in the observation group than in the control group (p < 0.05). At 1, 6, and 12 months after surgery, there was no significant difference in cosmetic results between both groups (p > 0.05). The overall complication rate in the observation group (6.82%) was lower than that in the control group (25.00%) (p < 0.05).ConclusionThe surgical and cosmetic results of e-PTFE frontalis suspension and frontalis flap suspension applied to congenital ptosis are comparable, but the former has the advantage of faster postoperative recovery, better ocular surface status, less frontali muscle strength damage and fewer complications.

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Histological findings of levator muscle in unilateral congenital ptosis in different age groups

Cited by 6 publications

References 12 publications

Modified Maximal Levator Palpebrae Superioris Shortening in Correcting Congenital Severe Ptosis in Children

Modified Maximal Levator Palpebrae Superioris Shortening in Correcting Congenital Severe Ptosis in Children

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

Application of e-PTFE Frontalis Suspension in the Treatment of Congenital Ptosis in Children

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