A new method of surgical upper eyelid ptosis treatment
https://doi.org/10.21516/2072-0076-2023-16-4-87-91
Abstract
Purpose: to develop a new method of surgical treatment of moderate upper eyelid ptosis.
Material and methods. 88 patients (106 eyes) aged 5–68 years (averagely 24.9 yrs), operated for moderate or severe upper eyelid ptosis, were divided into 3 groups depending on the degree of upper eyelid prolapse and levator function. Group I (43 patients, 47 eyes) had satisfactory mobility of the upper eyelid, its fold being smoothed or absent. Group II (15 patients, 15 eyes) had good mobility of the upper eyelid with a smoothed fold; this group was further divided into subgroups IIa and IIb depending on the technique of the operation. Group III (30 patients, 44 eyes) had low upper lid mobility (less than 4 mm) with no fold. Group I and subgroup IIa underwent a resection of the upper eyelid levator. In subgroup IIb, a new method was used: levatoroplasty with the formation of a levator duplicature. In group III, a suspension operation was performed to the frontalis muscle.
Results. In 10 cases (11 %), the results obtained by the new method of ptosis corrections were significantly better as compared to conventional resection: small edemas were resolved within a week, and the mobility of the upper eyelid levator was restored sooner.
Conclusion. The proposed technique showed good functional and cosmetic results, proved to be more sparing, retains all upper eyelid tissues and can be successfully used for moderate upper eyelid ptosis.
About the Authors
I. A. Filatova
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Irina A. Filatova — Dr. of Med. Sci., professor, chief researcher head of the department of plastic surgery and ophthalmic prosthetics
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062, Russia
Yu. P. Kondratyeva
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Yulia P. Kondratieva — Cand. of Med. Sci., head of the unit of plastic surgery and ophthalmic prosthetics
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062, Russia
S. A. Shemetov
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Sergey A. Shemetov — Cand. of Med. Sci., researcher of the department of plastic surgery and ophthalmic prosthetics
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062, Russia
M. S. Trefilova
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Marina S. Trefilova — PhD student of the department of plastic surgery and ophthalmic prosthetics
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062, Russia
References
1. Dray LP, Leibovitch I. Congenital ptosis and amblyopia: a retrospective study of 130 cases. J Pediatr Ophthalmol. Strabismus. 2002; 39 (4): 222–5. doi: 10.3928/0191-3913-20020701-10
2. Wong CY, Fan DS, Ng JS et al. Long-term results of autogenous palmaris longus frontalis sling in children with congenital ptosis. Eye. 2005; 19 (5): 546–8. doi: 10.1038/sj.eye.6701539
3. Grusha Y.O., Fisenko N.V., Blinova I.V. Blepharoptosis: diagnostic tests. Vestnik oftal'mologii. 2016; 132 (3): 61–5 (In Russ.). doi: 10.17116/oftalma2016132361-65
4. Tabashnikova T.V., Serova N.K., Shimanskiy V.N., Grigor'eva N.N. The use of botulinum toxin A (lantox) to obtain temporary drug-induced ptosis in neurosurgical patients. Voprosy neyrokhirurgii im. N.N. Burdenko. 2012; 76 (4): 19–25 (In Russ.).
5. Dadapeer K. Clinical methods in ophthalmology: Practical manual for undergraduates. New Delhi: JP Medical Ltd; 2013.
6. Filatova I.A. Diseases of the neuromuscular apparatus of the eyelids. In: Ophthalmology. National Guidelines. Moscow: GEOTAR-Media; 2008: 349–61 (In Russ.).
7. Cohen AJ, Weinberg DA. Evaluation and Management of Blepharoptosis. New York, NY: Springer New York; 2011.
8. Beard C. Ptosis. 3rd Ed. St. Louis: C.V. Mosby; 1981.
9. Hakimbashi M, Kikkawa DO, Korn BS. Complications of ptosis repair: Prevention and management. Chapter 30. In: Cohen AJ, Weinberg DA., eds. Evaluation and management of blepharoptosis. Springer Science, Busines Media, LLC; 2011: 275–87.
10. Filatova I.A., Shemetov S.A. A modified implant for upper eyelid ptosis correction in frontalis suspension surgery. Vestnik oftal’mologii. 2017; 133 (6): 69–75 (In Russ.). https://doi.org/10.17116/oftalma2017133669-75
11. Filatova I.A., Shemetov S.A. Analysis of complications due to incorrect tactics of surgical treatment of upper eyelid ptosis. Rossiyskaya pediatricheskaya oftal'mologiya. 2016; 11 (2): 89–92 (In Russ.). doi: 10.18821/1993-1859-2016-11-2-89-92
12. Epstein G, Putterman A. Super-maximum levator resection for severe unilateral congenital blepharoptosis. Ophthalmic Surgery. 1984: 15 (12): 971–9. PMID: 6395058
13. Cates CA, Tyers AG. Outcomes of anterior levator resection in congenital blepharoptosis. Eye. 2001; 15: 770–3. doi: 10.1038/eye.2001.247
14. Filatova I.A., Kondrat'eva Yu.P., Trefilova M.S., Shemetov S.A., Mokhammad I.M. A method for the surgical treatment of moderate and severe upper eyelid ptosis. Patent RU 2772534 C1 (In Russ.).
Review
For citations:
Filatova I.A., Kondratyeva Yu.P., Shemetov S.A., Trefilova M.S. A new method of surgical upper eyelid ptosis treatment. Russian Ophthalmological Journal. 2023;16(4):87-91. (In Russ.) https://doi.org/10.21516/2072-0076-2023-16-4-87-91
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