Recurrent Ptosis in a Patient With Blepharochalasis

Abstract

A 37-year-old woman presented with right upper eyelid blepharochalasis with ptosis. Right upper eyelid edema had occurred 2 to 3 times per year by 30 years old, although the frequency decreased with age. The edema occurred spontaneously and resolved within 1 to 2 days. She underwent a right levator tucking surgery at 22 years old, and the ptosis recurred 2 years postoperatively. She again underwent ptosis surgery with skin excision at 37 years old. The intraoperative findings showed a thin levator aponeurosis. The white line was therefore advanced to the upper tarsal edge, resulting in an appropriate height and curvature. Three months later, the patient's eyelid height was 1.5 mm higher with a little temporal peaking. The levator aponeurosis was histopathologically shown to contain many capillaries. The increased vascularity of the levator aponeurosis may contribute to recurrent bouts of edema resulting in stretching and disinsertion of the aponeurosis.

Stepwise surgery with variable adjustments for severe blepharochalasis with multiple chemical sensitivity: a case report

“…However, palpebral ptosis recurred after 3 months, suggesting the need for further surgery. Huemer et al and Takahashi et al reported similar cases of recurrence after surgery [14,15]. Although the immediate postoperative result was satisfactory, their patients also required a second operation.…”

Blepharochalasis: clinical and epidemiological characteristics, surgical strategy and prognosis-- a retrospective cohort study with 93 cases

“…Ptosis (48.39%) was the most common manifestation among these cases. Some scholars hypothesized that the probable site of the lesion was in the aponeurosis or its insertion [ 13 ], which required further histopathological support. The second common manifestation was the lacrimal gland prolapse (44.09%), which was occurred due to the atrophic changes of the orbital septum.1 As for the deformity of the lateral or inner canthal angle, the dehiscence of attachments of upper and lower eyelids to the lateral position and occasionally medial canthal tendons were considered as the main causative reasons [ 14 ].…”

Blepharochalasis:Clinical and Epidemiological Characteristics, Surgical Strategy and Prognosis-- A Retrospective Cohort Study with 93 Cases

“…Ptosis (48.39%) was the most common manifestation among these cases. Some scholars hypothesized that the probable site of the lesion was in the aponeurosis or its insertion [14], which required further histopathological support. The second common manifestation was the lacrimal gland prolapse (44.09%), which was occurred due to the atrophic changes of the orbital septum.1 As for the deformity of the lateral or inner canthal angle, the dehiscence of attachments of upper and lower eyelids to the lateral position and occasionally medial canthal tendons were considered as the main causative reasons [15].…”