Surgical Outcome of Epicanthus and  Telecanthus Correction by Double Z-Plasty  and Trans-Nasal Fixation with Prolene  Suture in Blepharophimosis Syndrome

Mandal, Sharmistha; Mandal, Aparna; Fleming, James C.; Goecks, Tara; Meador, Andrew G; Fowler, Brian

doi:10.7860/jcdr/2017/25651.9496

Cited by 6 publications

(4 citation statements)

References 17 publications

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“…Other surgical methods have achieved satisfactory results, but problems such as obvious postoperative scars require further improvement. 3,13–16…”

Section: Discussionmentioning

confidence: 99%

“…Other surgical methods have achieved satisfactory results, but problems such as obvious postoperative scars require further improvement. 3,[13][14][15][16] The incision of points D and H, as well as the Z-cross flap of the inner canthus and the V-Y flap of the outer canthus, reduce the tension generated in the horizontal direction, thus relieving the vertical tension. Our study found statistically significant differences in HPFL, IPD, IICD/HPFL, IICD/IPD, and MRD-1 levels before and after surgery.…”

Section: One-stage Surgery Can Effectively Correct Ocular Deformity I...mentioning

confidence: 99%

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Improvement of one-stage comprehensive operation technique for blepharophimosis-ptosis-epicanthus inversus syndrome

Mingyu,

Lehao,

Wuyan

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: This retrospective case series aimed to evaluate the clinical effect of a modified one-stage comprehensive surgical method for blepharophimosis-ptosis-epicanthus inversus syndrome (BPES). Methods: Twenty-five patients with BPES underwent a modified reverse Z-plastic surgery method to change the Epicanthus into two unequal V-shaped flaps and suture them alternately. The medial canthus ligament was partially incised, shortened, and sutured; the outer canthus was opened with a "V-Y" flap. The gray line of the outer canthus was cut to extend the eyelid margin length. Ptosis was corrected using the orbicularis oculi-frontalis cross-flap technique. We studied the internal canthal distance (IICD), interpupillary distance (IPD), horizontal palpebral fissure length (HPFL), marginal reflex distance-1 (MRD-1), IICD/IPD ratio, IICD/HPLF ratio, Vancouver Scar Scale (VSS), and overall postoperative satisfaction. Results: The 25 patients included 12 females and 13 males (8.3±6.8 years), 19 of whom had a family history of BPES. The mean value of IPD was 50.15±7.43 mm. IICD decreased from 39.38±2.39 mm preoperatively to 31.64±2.37 mm postoperatively, IICD/IPD from 0.80±0.12 preoperatively to 0.64±0.07 postoperatively (p<0.05), and IICD/HPLF from 1.98±0.33 preoperatively to 1.22±0.10 postoperatively (p<0.01). HPLF increased from 20.08±3.53 mm preoperatively to 26.04±1.36 mm postoperatively (p<0.01) and MRD-1 from -1.12±0.71 mm preoperatively to 3.24±0.47 mm postoperatively (p<0.01). The postoperative VSS score was 3.68 ±1.07. The patients’ satisfaction was 8.8±1.08, with a relatively high overall satisfaction. Conclusions: The corrective effect on patients with BPES was noticeable, improving the IICD/HLFL and IICD/IPD ratios. Postoperative scars were not evident, and patient satisfaction was high.

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“…Other surgical methods have achieved satisfactory results, but problems such as obvious postoperative scars require further improvement. 3,13–16…”

Section: Discussionmentioning

confidence: 99%

Section: One-stage Surgery Can Effectively Correct Ocular Deformity I...mentioning

confidence: 99%

Improvement of one-stage comprehensive operation technique for blepharophimosis-ptosis-epicanthus inversus syndrome

Mingyu,

Lehao,

Wuyan

et al. 2023

Plastic &Amp; Reconstructive Surgery

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“…Additionally, ptosis correction generates a vertical force, while Mustarde's double Z-plasty causes a horizontal force. So when both of these procedures are performed simultaneously, as in a one-stage correction, the tension created by each surgery opposes the other, and this can cause loosening of epicanthal correction and poor elevation of the upper eyelid [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…The first stage involves Mustarde's double Z-plasty with transnasal fixation with 4-0 prolene. The second stage is performed after three months, and this involves a lateral canthoplasty for horizontal lid fissure widening and a tarsofrontalis sling with a silicone rod for ptosis correction [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Blepharophimosis, Ptosis, and Epicanthus Inversus Syndrome: A Simple Remedy for Challenging Cases

Alkhairy¹,

Saeed²,

Saeed³

2022

Cureus

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A 14-year-old male presented to the outpatient department of ophthalmology with complaints of visual impairment. The patient was assessed with a detailed history and physical examination. Marked amblyopia was observed on inspection, and his best-corrected vision was 6/36 in both eyes with no further improvement. Both the anterior and posterior segments of the eyes were normal. A diagnosis of blepharophimosis, ptosis, and epicanthus inversus syndrome (BPES) was suspected. Surgery was initiated in two stages, with the first stage utilizing Mustarde's double Z-plasty to correct the epicanthus inversus and telecanthus. The second stage was done three months later, involving a tarsofrontalis sling with prolene sutures to correct ptosis. The success of this operation speaks to the efficacy of a two-stage procedure for remedying a syndrome as complex as BPES.

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Congenital Ptosis

2022

Albert and Jakobiec's Principles and Practice of Ophthalmology

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Surgical Outcome of Epicanthus and Telecanthus Correction by Double Z-Plasty and Trans-Nasal Fixation with Prolene Suture in Blepharophimosis Syndrome

Cited by 6 publications

References 17 publications

Improvement of one-stage comprehensive operation technique for blepharophimosis-ptosis-epicanthus inversus syndrome

Improvement of one-stage comprehensive operation technique for blepharophimosis-ptosis-epicanthus inversus syndrome

Blepharophimosis, Ptosis, and Epicanthus Inversus Syndrome: A Simple Remedy for Challenging Cases

Congenital Ptosis

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