Distinct Features in Koreans with Involutional Blepharoptosis

Kim, Chang Yeom; Lee, Sang Yeul

doi:10.1097/prs.0000000000001280

Cited by 16 publications

(18 citation statements)

References 13 publications

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“…Eyelids with a short non-fatty-deposit length may require a large amount of levator advancement or another surgical procedure, including combined Müller muscle resection or intraoperative conversion to suspension surgery. The incidence of fatty degeneration in the levator aponeurosis/LPS muscle is quite different among races [3,13]. Previous studies demonstrated fatty degeneration in almost all East Asian patients versus in only 25.6% of Caucasian patients [3,13].…”

Section: Discussionmentioning

confidence: 95%

“…Increased fatty deposition in the levator aponeurosis/LPS muscle causes weakness of the tractional force to the upper eyelid [2]. A previous study showed that a fatty deposit in the aponeurosis/LPS muscle is more prevalent in East Asians than in Caucasians [3], suggesting that fatty degeneration has a greater impact on the clinical aspects of aponeurotic blepharoptosis in East Asian patients. As far as we can determine, however, the influence of fatty degeneration on surgical outcomes of transcutaneous aponeurotic repair has not been explored in this population.…”

Section: Introductionmentioning

confidence: 97%

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Influence of fatty deposits in the levator aponeurosis/levator palpebrae superioris muscle on outcomes of aponeurotic repair in a Japanese population

Matsuda

Sakai

Takahashi

et al. 2018

Eye

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 97%

Influence of fatty deposits in the levator aponeurosis/levator palpebrae superioris muscle on outcomes of aponeurotic repair in a Japanese population

Matsuda

Sakai

Takahashi

et al. 2018

Eye

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“…The average LF was 8.7 mm, and 24.5% of the eyes were determined to have fair LF. Kim and Lee [22] reported that Korean patients with involutional ptosis had decreased LF compared to Caucasian patients. The authors suggested that decreased LF was another possible mechanism causing involutional ptosis in Koreans and could be attributed to weakening of the levator muscle or aponeurosis itself and heavier eyelids endogenous to Koreans.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Demographic Characteristics of Blepharoptosis in Korea: A 24-year Experience including 2,328 Patients

Lee

Son

Lee

et al. 2018

Korean J Ophthalmol

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PurposeTo describe the demographics, relative incidence of subtypes, and clinical characteristics of blepharoptosis in Korean patients.MethodsThis is a retrospective, observational case series consisting of 2,328 patients who underwent ptosis surgery from 1991 to 2014 at a tertiary referral hospital in Korea. The patients were classified according to the type of ptosis and the evaluation of clinical characteristics including levator muscle function (LF) and degree of ptosis.ResultsOf the 2,328 patients, 1,815 (78%) had congenital ptosis and 513 (22%) had acquired ptosis. Simple congenital ptosis is the most common type overall (73.7%), and aponeurotic ptosis is the most common acquired type. More than three-quarters of eyes with congenital ptosis were affected in a moderate (34.4%) to severe degree (41.3%), and most of these eyes had fair (33.7%) to poor LF (60.1%). Among eyes with acquired ptosis, approximately three-quarters were affected in a mild (33.3%) to moderate degree (41.0%), with 63.3% of these eyes having good LF. The most widely used surgical technique was frontalis suspension (55.1%), followed by levator resection (29.0%) and aponeurosis repair (14.8%). At 3 years after the first surgery, 15.7% of patients with congenital ptosis and 10.4% of patients with acquired ptosis underwent reoperation.ConclusionsAlthough the prevalence has decreased from previous years, the proportion of cases with congenital ptosis was higher in this study than has been shown in research conducted in the West. The majority of eyes with congenital ptosis was affected to a severe degree and had poor LF, while those with acquired ptosis were affected to a moderate degree and had good LF. More cases with acquired ptosis presented with fair to poor LF, and frontalis suspension surgery was performed more commonly compared to previous studies. The reoperation rate was higher in congenital ptosis compared to acquired ptosis.

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“…Furthermore, there may be some racial differences in the condition of levator aponeurosis. According to a recent report, involutional ptosis results mainly from disinsertion of aponeurosis from the tarsal plate in Caucasians, while the decreased levator function with fatty infiltration is found in Korean patients . Thus, blepharoptosis should be repaired with the consideration of these racial differences.…”

Section: Discussionmentioning

confidence: 99%

“…According to a recent report, involutional ptosis results mainly from disinsertion of aponeurosis from the tarsal plate in Caucasians, while the decreased levator function with fatty infiltration is found in Korean patients. 30 Thus, blepharoptosis should be repaired with the consideration of these racial differences. In the absence of definite dermatochalasis, patients with sunken superior sulcus may benefit from HA filler injection or fat graft.…”

Section: Discussionmentioning

confidence: 99%