Physiological Correction of Mild to Moderate Congenital Blepharoptosis

 A Retrospective Cohort Study Involving 97 Eastern Asian patients:

Publication date: Available online 2 March 2019

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Fei Liu, Yan Ma, Zhaoqi Yuan, Xusong Luo, Qun Yang, Jun Yang, Ming Zhu, Xianyu Zhou

ABSTRACT

Background

Conventional blepharoptosis repair methods distort normal anatomy of levator aponeurosis and often cause a visible depressed scar in the upper eyelid.

Methods

The levator aponeurosis was dissected as a flap from the pretarsal tissue in mono-eyelid Asian patients who had mild to moderate congenital blepharoptosis. The flap base was advanced and repositioned on the tarsus. The margin of distal flap was interposed and fused with orbicularis oculi muscles. Postoperative evaluation was comprised of ptosis correction, symmetry, and overall cosmetic outcomes.

Results

A total of 162 eyes on 97 patients were corrected using our method. Follow-up time ranged from 8 to 24 months (mean 12.4). Out of 58 mild ptosis eyelids, 36.2% (21 eyelids), 56.9% (33) and 6.9% (4) resulted in the adequate correction, normal correction and undercorrection respectively. In moderate ptosis, these results were 34.6% (36 eyelids), 53.9% (56) and 11.5% (12). In symmetry, 58.8% (57 cases), 32.0% (31) and 9.2% (9) resulted in good, fair and poor outcomes accordingly. 82.8% (48 eyelids), 15.5% (9) and 1.7 % (1) of mild ptosis cases achieved good, moderate and poor results. In moderate ptosis cases, these numbers were 77.9% (81 eyes), 20.2% (21) and 1.9% (2) respectively. The only complication amongst all cases was postoperative swelling.

Conclusions

We presented a new blepharoplasty for ptosis repair that allows both satisfactory ptosis correction and cosmetic outcomes in mild to moderate congenital blepharoptosis.