Open loop fascial sling for severe congenital blepharoptosis

Arajy, Zakaria Y.

doi:10.1016/j.jcms.2011.03.002

Cited by 22 publications

(9 citation statements)

References 11 publications

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“…12 Arajy reported that an 8-cm Â 0.5-cm fascia lata strip should be harvested in his 'open loop fascial sling' procedure. 13 Gundelioglu et al used a 5-cm thigh incision to harvest a relatively large en-bloc tensor fascia lata sheet. 14 However, the use of such long strands of fascia lata in the upper eyelid is unnecessarily cumbersome.…”

Section: Discussionmentioning

confidence: 99%

Intra-eyebrow frontalis suspension using inverted Y-shaped short autogenous fascia lata for blepharoptosis with poor levator function

Shimizu

Nagasao

Shido

et al. 2015

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Section: Discussionmentioning

confidence: 99%

Intra-eyebrow frontalis suspension using inverted Y-shaped short autogenous fascia lata for blepharoptosis with poor levator function

Shimizu

Nagasao

Shido

et al. 2015

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…Frontalis suspension has been described using autogenous tendons [15], fascia lata strips [12], and autogenous temporal fascia [12]. Arajy et al [16] described an open loop fascial sling for the treatment of severe congenital blepharoptosis and reported a satisfaction rate of 77% and found that unsatisfactory results were primarily due to under correction (10%) and poor lid crease (6%). Bhiromekraibhak et al [17] described a technique using a double breast frontalis-orbicularis oculi muscle flap which the authors indicate enhances the mobility and amount of pretarsal orbicularis oculi muscle.…”

Section: Discussionmentioning

confidence: 99%

Frontalis Muscle Flap Suspension for the Correction of Congenital Blepharoptosis in Early Age Children

Hou

Lin

et al. 2013

PLoS ONE

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BackgroundWe aimed to report our successful use of frontalis muscle flap suspension for the correction of congenital blepharoptosis in early age children.MethodsThis retrospective study included 61 early age children (41 boys, 20 girls) with an average age of 6 years (range, 3–10 years) with congenital blepharoptosis who received surgery during the period from March 2007 to January 2011. There were 39 cases of unilateral blepharoptosis and 22 cases of bilateral blepharoptosis, thus a total of 83 eyes were affected. If patient had bilateral blepharoptosis, both eyes were operated on in the same surgery. Patients were followed for 3 months to 5 years. The procedure was performed without complications in all cases.ResultsThe postoperative healing grade was good in 81 eyes (97.6%); the correction of blepharoptosis was satisfactory, the double eyelid folds were natural and aesthetic, the eyelid position and the curvature were ideal, and the eyes were bilaterally symmetrical. The postoperative healing grade was fair in 2 eyes (2.4%); blepharoptosis was improved compared with that before surgery. At discharge, lagophthalmos was noted in 10 eyes of which 4 cases resolved by the last follow-up. The remaining 6 cases were mild. Eleven eyes received reoperation for residual ptosis after the first surgery. The curvature of the palpebral margin was not natural in 4 eyes. These unnatural curvature possibly was caused by an excessively low lateral fixation point or postoperative avulsion.ConclusionFrontalis muscle flap suspension under general anesthesia for the correction of congenital blepharoptosis in early age children can achieve good surgical results.

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“…The frontalis muscle provides both functions of suspension and elevation. [ 35 ] The important goal of the surgery is to raise the eyelid by creating a direct connection between the frontalis muscle and the tarsal plate of the upper lid. This allows an elevating force to be transmitted to the eyelid during contraction of the frontalis muscle, in addition to a suspensory force in primary gaze.…”

Section: Frontalis Suspension Surgerymentioning

confidence: 99%

“…Patients with unilateral surgery unconsciously adjust relatively well to unilateral lagophthalmos and lid lag, both becoming less apparent by voluntary orbicularis contraction with time. [ 12 ] Unilateral frontalis suspension[ 18 32 35 ] and maximal levator resection[ 20 21 22 26 27 28 34 ] have been recommended as approaches that intervene only on the deficient side.…”

Section: Frontalis Suspension Surgerymentioning

confidence: 99%

Surgical treatment of unilateral severe simple congenital ptosis

Lee

Kim

2018

Taiwan J Ophthalmol

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Unilateral congenital ptosis with poor levator function of ≤4 mm continues to be a difficult challenge for the oculoplastic surgeon. Surgical correction can be accomplished with unilateral frontalis suspension, maximal levator resection, or bilateral frontalis suspension with or without levator muscle excision of the normal eyelid. Bilateral frontalis suspension was proposed by Beard and Callahan to overcome the challenge of postoperative asymmetry, allowing symmetrical lagophthalmos on downgaze, postoperatively. However, most surgeons and patients prefer unilateral correction on the abnormal eyelid either with a frontalis suspension or maximal levator resection. Frontalis suspension may be performed through the various surgical techniques using different autogenous or exogenous materials. Autogenous fascia lata is considered the material of choice with low recurrence rates but carries the drawbacks of the difficulty of harvesting and postoperative morbidity from the second surgical site. Recent reports have suggested that maximal levator resection provides improved cosmesis, a more natural contour, and avoids brow scars. Although both treatments have shown to have similar success rates, there is much debate about what the most favorable method for treating severe unilateral ptosis. We review the literature on the various surgical treatments for unilateral severe congenital ptosis, including the rationale, advantages and disadvantages of each technique.

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Open loop fascial sling for severe congenital blepharoptosis

Cited by 22 publications

References 11 publications

Intra-eyebrow frontalis suspension using inverted Y-shaped short autogenous fascia lata for blepharoptosis with poor levator function

Intra-eyebrow frontalis suspension using inverted Y-shaped short autogenous fascia lata for blepharoptosis with poor levator function

Frontalis Muscle Flap Suspension for the Correction of Congenital Blepharoptosis in Early Age Children

Surgical treatment of unilateral severe simple congenital ptosis

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