Skip to main content
Top
Published in: Aesthetic Plastic Surgery 3/2020

01-06-2020 | Ptosis | Original Article

A New Surgical Technique Used for Correction of Congenital Blepharoptosis

Authors: Xiaoteng Miao, Tailing Wang, Xu Zhou, Weiming Song, Jiaqi Wang

Published in: Aesthetic Plastic Surgery | Issue 3/2020

Login to get access

Abstract

Background

Blepharoptosis is defined as the drooping or lower displacement of the upper eyelids. Various kinds of surgical techniques and modifications have been introduced to improve the surgical outcomes, but the high recurrence rate and unsatisfying cosmetic results remain as a common problem.

Purpose

To solve the problem mentioned above, we came up with our new surgical technique and conducted a retrospective review to verify its effectiveness.

Patients and Methods

A retrospective review was conducted among the patients diagnosed as genuine congenital blepharoptosis and receiving the surgical treatments where our unique technique was used between January 2016 and January 2019. The clinical records and preoperative and postoperative photographs were collected and evaluated.

Results

A total of 83 patients were included in our study, 78 (94%) of them acquired good surgical outcomes, while 4 (4.8%) of them got fair results, and 1 (1.2%) of them got a poor result. No long-term lagophthalmos, ectropion, entropion and fornix conjunctival prolapse were noted.

Conclusions

Our surgical technique introduced here is effective in the management of genuine congenital blepharoptosis.

Level of Evidence III

For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Appendix
Available only for authorised users
Literature
1.
go back to reference Finsterer J (2003) Ptosis: causes, presentation, and management. Aesthetic Plast Surg 27(3):193–204CrossRef Finsterer J (2003) Ptosis: causes, presentation, and management. Aesthetic Plast Surg 27(3):193–204CrossRef
2.
go back to reference Griepentrog GJ, Diehl NN, Mohney BG (2011) Incidence and demographics of childhood ptosis. Ophthalmology 118(6):1180–1183CrossRef Griepentrog GJ, Diehl NN, Mohney BG (2011) Incidence and demographics of childhood ptosis. Ophthalmology 118(6):1180–1183CrossRef
3.
go back to reference Sakol PJ, Mannor G, Massaro BM (1999) Congenital and acquired blepharoptosis. Curr Opin Ophthalmol 10(5):335–339CrossRef Sakol PJ, Mannor G, Massaro BM (1999) Congenital and acquired blepharoptosis. Curr Opin Ophthalmol 10(5):335–339CrossRef
4.
go back to reference Hu DN (1988) Prevalence and mode of inheritance of major genetic eye diseases in China. Acta genetica Sinica. 15(3):231–236PubMed Hu DN (1988) Prevalence and mode of inheritance of major genetic eye diseases in China. Acta genetica Sinica. 15(3):231–236PubMed
5.
go back to reference El Essawy R, Elsada MA (2013) Clinical and demographic characteristics of ptosis in children: a national tertiary hospital study. Eur J Ophthalmol 23(3):356–360CrossRef El Essawy R, Elsada MA (2013) Clinical and demographic characteristics of ptosis in children: a national tertiary hospital study. Eur J Ophthalmol 23(3):356–360CrossRef
6.
go back to reference Yadegari S (2016) Approach to a patient with blepharoptosis. Neurol Sci 37(10):1589–1596CrossRef Yadegari S (2016) Approach to a patient with blepharoptosis. Neurol Sci 37(10):1589–1596CrossRef
7.
go back to reference Song R, Song Y (1982) Treatment of blepharoptosis. Direct transplantation of the frontalis muscle to the upper eyelid. Clin Plast Surg 9(1):45–48PubMed Song R, Song Y (1982) Treatment of blepharoptosis. Direct transplantation of the frontalis muscle to the upper eyelid. Clin Plast Surg 9(1):45–48PubMed
8.
go back to reference Buttanri IB, Serin D, Karslioglu S, Akbaba M, Ari S, Fazil K (2013) Effect of suturing the silicone rod to the tarsal plate and the suture material used on success of frontalis suspension surgery. Ophthalmic Plast Reconstr Surg 29(2):98–100CrossRef Buttanri IB, Serin D, Karslioglu S, Akbaba M, Ari S, Fazil K (2013) Effect of suturing the silicone rod to the tarsal plate and the suture material used on success of frontalis suspension surgery. Ophthalmic Plast Reconstr Surg 29(2):98–100CrossRef
9.
go back to reference DeMartelaere SL, Blaydon SM, Cruz AA, Amato MM, Shore JW (2007) Broad fascia fixation enhances frontalis suspension. Ophthalmic Plast Reconstr Surg 23(4):279–284CrossRef DeMartelaere SL, Blaydon SM, Cruz AA, Amato MM, Shore JW (2007) Broad fascia fixation enhances frontalis suspension. Ophthalmic Plast Reconstr Surg 23(4):279–284CrossRef
10.
go back to reference Zhang HM, Sun GC, Song RY et al (1999) 109 cases of blepharoptosis treated by forked frontalis muscle aponeurosis procedure with long term follow-up. Br J Plast Surg 52(7):524–529CrossRef Zhang HM, Sun GC, Song RY et al (1999) 109 cases of blepharoptosis treated by forked frontalis muscle aponeurosis procedure with long term follow-up. Br J Plast Surg 52(7):524–529CrossRef
11.
go back to reference Jordan DR, Anderson RL (1990) The aponeurotic approach to congenital ptosis. Ophthalmic Surg 21(4):237–244PubMed Jordan DR, Anderson RL (1990) The aponeurotic approach to congenital ptosis. Ophthalmic Surg 21(4):237–244PubMed
12.
go back to reference Zuo L, Wang XX, Huang XY, Zhang JL, Du YY (2017) A modified levator resection technique involving retention of the levator palpebrae superioris muscle suspension system for treatment of congenital ptosis. Aesthetic Plast Surg 41(4):856–862CrossRef Zuo L, Wang XX, Huang XY, Zhang JL, Du YY (2017) A modified levator resection technique involving retention of the levator palpebrae superioris muscle suspension system for treatment of congenital ptosis. Aesthetic Plast Surg 41(4):856–862CrossRef
13.
go back to reference Al-Abbadi Z, Sagili S, Malhotra R (2014) Outcomes of posterior-approach 'levatorpexy' in congenital ptosis repair. Br J Ophthalmol 98(12):1686–1690CrossRef Al-Abbadi Z, Sagili S, Malhotra R (2014) Outcomes of posterior-approach 'levatorpexy' in congenital ptosis repair. Br J Ophthalmol 98(12):1686–1690CrossRef
14.
go back to reference Frueh BR, Musch DC, McDonald HM (2004) Efficacy and efficiency of a small-incision, minimal dissection procedure versus a traditional approach for correcting aponeurotic ptosis. Ophthalmology 111(12):2158–2163CrossRef Frueh BR, Musch DC, McDonald HM (2004) Efficacy and efficiency of a small-incision, minimal dissection procedure versus a traditional approach for correcting aponeurotic ptosis. Ophthalmology 111(12):2158–2163CrossRef
15.
go back to reference Lee JH, Nam SM, Kim YB (2015) Blepharoptosis correction: levator aponeurosis-Muller muscle complex advancement with three partial incisions. Plast Reconstr Surg 135(2):388–395CrossRef Lee JH, Nam SM, Kim YB (2015) Blepharoptosis correction: levator aponeurosis-Muller muscle complex advancement with three partial incisions. Plast Reconstr Surg 135(2):388–395CrossRef
16.
go back to reference Martin JJ Jr (2015) Upper eyelid blepharoplasty with ptosis repair by levator aponeurectomy. JAMA Facial Plast Surg 17(3):224–225CrossRef Martin JJ Jr (2015) Upper eyelid blepharoplasty with ptosis repair by levator aponeurectomy. JAMA Facial Plast Surg 17(3):224–225CrossRef
17.
go back to reference Emsen IM (2008) A new ptosis correction technique: a modification of levator aponeurosis advancement. J Craniofacial Surg. 19(3):669–674CrossRef Emsen IM (2008) A new ptosis correction technique: a modification of levator aponeurosis advancement. J Craniofacial Surg. 19(3):669–674CrossRef
18.
go back to reference McCulley TJ, Kersten RC, Kulwin DR, Feuer WJ (2003) Outcome and influencing factors of external levator palpebrae superioris aponeurosis advancement for blepharoptosis. Ophthalmic Plast Reconstr Surg 19(5):388–393CrossRef McCulley TJ, Kersten RC, Kulwin DR, Feuer WJ (2003) Outcome and influencing factors of external levator palpebrae superioris aponeurosis advancement for blepharoptosis. Ophthalmic Plast Reconstr Surg 19(5):388–393CrossRef
19.
go back to reference Skaat A, Fabian D, Spierer A, Rosen N, Rosner M, Ben Simon GJ (2013) Congenital ptosis repair-surgical, cosmetic, and functional outcome: a report of 162 cases. Can J Ophthalmol 48(2):93–98CrossRef Skaat A, Fabian D, Spierer A, Rosen N, Rosner M, Ben Simon GJ (2013) Congenital ptosis repair-surgical, cosmetic, and functional outcome: a report of 162 cases. Can J Ophthalmol 48(2):93–98CrossRef
20.
go back to reference Ben Simon GJ, Lee S, Schwarcz RM, McCann JD, Goldberg RA (2005) External levator advancement vs. Muller's muscle-conjunctival resection for correction of upper eyelid involutional ptosis. Am J Ophthalmol 140(3):426–432CrossRef Ben Simon GJ, Lee S, Schwarcz RM, McCann JD, Goldberg RA (2005) External levator advancement vs. Muller's muscle-conjunctival resection for correction of upper eyelid involutional ptosis. Am J Ophthalmol 140(3):426–432CrossRef
21.
go back to reference Whitehouse GM, Grigg JR, Martin FJ (1995) Congenital ptosis: results of surgical management. Aust N Z J Ophthalmol 23(4):309–314CrossRef Whitehouse GM, Grigg JR, Martin FJ (1995) Congenital ptosis: results of surgical management. Aust N Z J Ophthalmol 23(4):309–314CrossRef
22.
go back to reference Yoon JS, Lee SY (2009) Long-term functional and cosmetic outcomes after frontalis suspension using autogenous fascia lata for pediatric congenital ptosis. Ophthalmology 116(7):1405–1414CrossRef Yoon JS, Lee SY (2009) Long-term functional and cosmetic outcomes after frontalis suspension using autogenous fascia lata for pediatric congenital ptosis. Ophthalmology 116(7):1405–1414CrossRef
23.
24.
go back to reference Souther SG, Vistnes LM (1979) Experience with the Fasanella-Servat operation for ptosis of the upper eyelid. Ann Plast Surg 3(6):540–543CrossRef Souther SG, Vistnes LM (1979) Experience with the Fasanella-Servat operation for ptosis of the upper eyelid. Ann Plast Surg 3(6):540–543CrossRef
25.
go back to reference Wang T, Li X, Wang X et al (2017) Evaluation of moderate and severe blepharoptosis correction using the interdigitated part of the frontalis muscle and orbicularis oculi muscle suspension technique: A cohort study of 235 cases. J Plast Reconstr Aesthetic Surg: JPRAS. 70(5):692–698CrossRef Wang T, Li X, Wang X et al (2017) Evaluation of moderate and severe blepharoptosis correction using the interdigitated part of the frontalis muscle and orbicularis oculi muscle suspension technique: A cohort study of 235 cases. J Plast Reconstr Aesthetic Surg: JPRAS. 70(5):692–698CrossRef
26.
go back to reference SooHoo JR, Davies BW, Allard FD, Durairaj VD (2014) Congenital ptosis. Surv Ophthalmol 59(5):483–492CrossRef SooHoo JR, Davies BW, Allard FD, Durairaj VD (2014) Congenital ptosis. Surv Ophthalmol 59(5):483–492CrossRef
27.
go back to reference Johnson CC (1985) Super-maximum levator resection for severe unilateral congenital blepharoptosis. Ophthalmic Surg 16(8):512–513PubMed Johnson CC (1985) Super-maximum levator resection for severe unilateral congenital blepharoptosis. Ophthalmic Surg 16(8):512–513PubMed
28.
go back to reference Older JJ (1983) Levator aponeurosis surgery for the correction of acquired ptosis. Analysis of 113 procedures. Ophthalmology 90(9):1056–1059CrossRef Older JJ (1983) Levator aponeurosis surgery for the correction of acquired ptosis. Analysis of 113 procedures. Ophthalmology 90(9):1056–1059CrossRef
29.
go back to reference Pan Y, Zhang H, Yang L et al (2008) Correction of congenital severe ptosis by suspension of a frontal muscle flap overlapped with an inferiorly based orbital septum flap. Aesthetic Plast Surg 32(4):604–612; discussion 613 Pan Y, Zhang H, Yang L et al (2008) Correction of congenital severe ptosis by suspension of a frontal muscle flap overlapped with an inferiorly based orbital septum flap. Aesthetic Plast Surg 32(4):604–612; discussion 613
30.
go back to reference Han K, Kang J (1993) Tripartite frontalis muscle flap transposition for blepharoptosis. Ann Plast Surg 30(3):224–232CrossRef Han K, Kang J (1993) Tripartite frontalis muscle flap transposition for blepharoptosis. Ann Plast Surg 30(3):224–232CrossRef
31.
go back to reference Liu F, Yang F, Luo XS, Dong JS, Chin B, Yang J (2012) A modified technique combining excision of the levator muscle and tarsus for blepharoptosis in Asians: a 6-year experience with 116 cases. Aesthetic Plast Surg 36(1):41–48CrossRef Liu F, Yang F, Luo XS, Dong JS, Chin B, Yang J (2012) A modified technique combining excision of the levator muscle and tarsus for blepharoptosis in Asians: a 6-year experience with 116 cases. Aesthetic Plast Surg 36(1):41–48CrossRef
32.
go back to reference Seider N, Beiran I, Kaltreider SA (2006) One medial triangular Tutoplast sling as a frontalis suspension for adult myogenic blepharoptosis. Acta Ophthalmol Scand 84(1):121–123CrossRef Seider N, Beiran I, Kaltreider SA (2006) One medial triangular Tutoplast sling as a frontalis suspension for adult myogenic blepharoptosis. Acta Ophthalmol Scand 84(1):121–123CrossRef
33.
go back to reference Ibrahim HA (2007) Use of the levator muscle as a frontalis sling. Ophthalmic Plast Reconstr Surg 23(5):376–380CrossRef Ibrahim HA (2007) Use of the levator muscle as a frontalis sling. Ophthalmic Plast Reconstr Surg 23(5):376–380CrossRef
34.
go back to reference Ho YF, Wu SY, Tsai YJ (2017) Factors associated with surgical outcomes in congenital ptosis: a 10-year study of 319 cases. Am J Ophthalmol 175:173–182CrossRef Ho YF, Wu SY, Tsai YJ (2017) Factors associated with surgical outcomes in congenital ptosis: a 10-year study of 319 cases. Am J Ophthalmol 175:173–182CrossRef
Metadata
Title
A New Surgical Technique Used for Correction of Congenital Blepharoptosis
Authors
Xiaoteng Miao
Tailing Wang
Xu Zhou
Weiming Song
Jiaqi Wang
Publication date
01-06-2020
Publisher
Springer US
Keyword
Ptosis
Published in
Aesthetic Plastic Surgery / Issue 3/2020
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-019-01577-1

Other articles of this Issue 3/2020

Aesthetic Plastic Surgery 3/2020 Go to the issue