J Korean Ophthalmol Soc.  2012 Dec;53(12):1737-1741. 10.3341/jkos.2012.53.12.1737.

Effect of the Simultaneous Operation of Levator Resection and Frontalis Suspension for Congenital Ptosis

• Kim AR
• Choi CW
• Kim SD

• KMID: 2216384
• DOI: http://doi.org/10.3341/jkos.2012.53.12.1737

Abstract

PURPOSE
To determine retrospectively if a simultaneous frontalis suspension could change the result of undercorrection observed during levator resection in congenital ptosis patients with poor levator functions.
METHODS
Eight eyes in the present study were from 5 infants, 4 infants had congenital ptosis and 1 infant had blepharophimosis. The average age was 3.3 years (range: 1.5 to 6.9 years). If the upper lid margin was not positioned on the superior limbus after performing levator resection under general anesthesia, the height of the upper lid margin was controlled by simultaneous frontalis suspension.
RESULTS
The average follow-up period was 29.8 months. After surgery on both eyes, all 8 cases showed good results and sudden relapse did not occur. Exposed corneal erosion was observed in 6 eyes, but with artificial tears, eye drops, and ointment there were significant improvements within 1 month in all cases. At final examinations, 6 out of 8 eyes showed excellent or good results; undercorrection in 2 eyes was observed and the lateral portion of ptosis in 1 eye was observed as an eye complication.
CONCLUSIONS
If undercorrection caused by levator resection occurs in patients with congenital ptosis, the combination of frontalis suspension surgery may reduce undercorrection and any recurrence that might appear after surgery.

Keyword

Congenital ptosis; Frontalis suspension; Levator resection

MeSH Terms

Anesthesia, General
Blepharophimosis
Eye
Follow-Up Studies
Humans
Infant
Ophthalmic Solutions
Recurrence
Retrospective Studies
Ophthalmic Solutions

Figure

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  Figure 1 The procedure of the simultaneous levator resection and frontalis suspension for congenital ptosis. The procedure was performed from A to H. The upper lid margin was positioned to superior limbus level.

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  Figure 2 Photograph show excellent results in both eyes after performing our procedure for congenital ptosis. (A) Preoperative photograph. (B) Intraoperative photograph after the last procedure. (C) Postoperative photograph after 13 months.

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  Figure 3 Blepharophimosis infant shows undercorrection after 15 months follow-up. (A) Preoperative photograph. (B) Intraoperative photograph after the last procedure. (C) Postoperative the last follow-up photograph.

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