Frontalis sling operation using silicone rod for the correction of ptosis in chronic progressive external ophthalmoplegia

Ahn, Jeeyun; Kim, Namju; Choung, Ho Kyung; Hwang, Sang Won; Sung, Myongsoon; Lee, Min Joung; Khwarg, Sang In

doi:10.1136/bjo.2008.144816

Cited by 38 publications

(19 citation statements)

References 12 publications

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“…This could be the consequence of a selection bias, excluding cases with more severe dryness from surgery, or might indicate an actual overestimation of the risk for corneal complications postoperatively. Our findings are in agreement with a recent study by Ahn et al, who reported on their experience with frontalis suspension in seven patients with CPEO (Ahn et al 2008).…”

Section: Discussionsupporting

confidence: 94%

Exposure keratopathy following silicone frontalis suspension in adult neuro‐ and myogenic ptosis

Sorge

Devogelaere

Sotodeh

et al. 2012

Acta Ophthalmologica

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. Purpose: To evaluate the incidence of exposure keratopathy following silicone frontalis suspension in adult neuro‐ and myogenic blepharoptosis. Method: Retrospective noncomparative analysis of the charts of 69 cases (101 eyelids) of silicone frontalis suspension. Results: Sixty‐one patients (93 eyelids) had myogenic ptosis, and eight patients (eight eyelids) had neurogenic ptosis. Preoperative diagnoses included chronic progressive external ophthalmoplegia, myotonic dystrophy, oculopharyngeal dystrophy, third cranial nerve palsy because of trauma or other causes. Average age at the time of operation was 54. Mean interval between the intervention and the first and second postoperative control was 8 and 28 months, respectively. Thirty‐one patients (31 eyelids) needed a second follow‐up visit. Postoperative punctate epithelial erosions (PEE) were encountered most frequently in patients with Steinert’s disease (42% of eyes) and congenital ptosis (33% of eyes). Patients with oculopharyngeal dystrophy did not develop PEE. Corneal ulceration developed in three eyes (two patients): one eye was successfully treated with local antibiotic ointments and lubricants, a bilateral corneal ulceration in the second patient was successfully treated with partial conjunctival grafts. Conclusion: This study cohort demonstrated a 26% risk of exposure keratopathy following silicone frontalis suspension. The risk of major corneal complications, such as ulceration, was low (3%).

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Section: Discussionsupporting

confidence: 94%

Exposure keratopathy following silicone frontalis suspension in adult neuro‐ and myogenic ptosis

Sorge

Devogelaere

Sotodeh

et al. 2012

Acta Ophthalmologica

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“…Strabismus or ptosis surgery may be helpful for patients with CPEO who have diplopia or vision-limiting ptosis 3,248. Lid surgery must be undertaken with care, as weakness of the orbicularis oculi in CPEO commonly results in lagophthalmos and ectropion, predisposing the patient to exposure keratopathy 49,214.…”

Section: Treatment Of Mitochondrial Diseasementioning

confidence: 99%

The Neuro-ophthalmology of Mitochondrial Disease

Fraser

Biousse

Newman

2010

Survey of Ophthalmology

221

250

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Mitochondrial diseases frequently manifest neuro-ophthalmologic symptoms and signs. Because of the predilection of mitochondrial disorders to involve the optic nerves, extraocular muscles, retina, and even the retrochiasmal visual pathways, the ophthalmologist is often the first physician to be consulted. Disorders caused by mitochondrial dysfunction can result from abnormalities in either the mitochondrial DNA or in nuclear genes which encode mitochondrial proteins. Inheritance of these mutations will follow patterns specific to their somatic or mitochondrial genetics. Genotype-phenotype correlations are inconstant, and considerable overlap may occur among these syndromes. The diagnostic approach to the patient with suspected mitochondrial disease entails a detailed personal and family history, careful ophthalmic, neurologic, and systemic examination, directed investigations, and attention to potentially life-threatening sequelae. Although curative treatments for mitochondrial disorders are currently lacking, exciting research advances are being made, particularly in the area of gene therapy. Leber hereditary optic neuropathy, with its window of opportunity for timely intervention and its accessibility to directed therapy, offers a unique model to study future therapeutic interventions. Most patients and their relatives benefit from informed genetic counseling.

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“…21 J Ahn ve ark. 22 KPEO'lu 7 hastanın 12 gözüne silikon rod ile frontal askı cerrahisi uyguladıkları çalışmalarında bütün hastalarda optimal kapak yükseltilmesini sağladıklarını, 5 hastada korneal epitel defektleri görüldüğünü, lubrikan tedavi ile düzelme sağlandığını belirtmişlerdir. Argın ve ark.…”

Section: Discussionunclassified

Kronik Progresif Eksternal Oftalmoplejili Hastalarda Pitozis Cerrahisi Sonuçları

Uğurlu¹,

Atik²,

Işık³

et al. 2014

tjo

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Objectives: To evaluate the clinical features and the outcome of ptosis surgery in patients with chronic progressive external ophthalmoplegia (CPEO). Materials and Methods: The demographic features, surgical approaches, anatomic and functional outcomes, and complications were reviewed in patients with CPEO who had undergone ptosis surgery by a single surgeon between the years 2005 and 2013. The patients were asked to evaluate their postoperative result as either worse, no change, good, or very good. Results: Seven men and 5 women with an average age of 50±14.08 years (range: 28-72) were included in the study. Ragged red fibers (RRF) were identified in 5 out of 9 patients' levator and orbicularis muscle biopsy specimens. Average levator function was 5.4±2.6 mm (range: 2-9). Frontalis suspension surgery with silicone rod was performed in 8 patients; two of those 8 patients had lower lid elevation with hard palate graft prior to ptosis surgery. The remaining 4 patients had levator resection. Postoperative margin reflex distance -1 was between +1 and +3 in all patients. One patient had punctate keratopathy following surgery, which responded rapidly to intensive use of lubricants. Head position was improved in all patients; postoperative result was rated 'very good'. Conclusion: Eyelid elevation must be tailored to result in sufficient interpalpebral area so as to allow for normal visual function and avoid exposure keratopathy. Lower eyelid elevation with hard palate graft may help to achieve this goal by displacing the interpalpebral area superiorly without introducing additional risk for corneal exposure. (Turk J Ophthalmol 2014; 44: 379-83) Amaç: Kronik progresif eksternal oftalmopleji (KPEO) tanısı ile izlenen ve pitozis cerrahisi uygulanmış hastaların bulgu ve tedavi sonuçlarının değerlendirilmesi. Gereç ve Yöntem: Bu çalışmada 2005-2013 yılları arasında KPEO tanısı ile izlenen ve tek cerrah tarafından pitozis cerrahisi uygulanan hastaların dosyaları demografik veriler, cerrahi yöntem, anatomik ve fonksiyonel başarı, komplikasyonlar açısından değerlendirildi. Hastalardan cerrahi sonuçlarını 'daha kötü', 'değişim yok', 'iyi' veya 'çok iyi' şeklinde tanımlamaları istendi. Bulgular: Ortalama yaşı 50±14,08 (sınırlar; 28-72) olan 7 erkek 5 kadın olgu çalışmaya dahil edildi. 'Ragged red fibers' (RRF), levator ve orbikülaris kas biyopsisi alınan 9 hastanın 5'inde izlendi. Olguların ortalama levator fonksiyonu 5,4±2,6 mm (sınırlar; 2-9) idi. Sekiz olguya silikon rod ile frontal askı cerrahisi yapıldı; bu hastalardan ikisine daha önce sert damak grefti ile alt kapak elevasyonu girişimi uygulanmıştı. Kalan 4 olguya ise levator rezeksiyonu yapılmıştı. Postoperatif kornea reflesi-kapak kenarı mesafesi -1 değeri +1 ile +3 arasında idi. Postoperatif izlemde sadece bir olguda korneal punktat epitelyopati görüldü; yoğun lubrikan tedavisi ile hızla düzeldi. Tüm olgularda baş pozisyonunda düzelme sağlandı; cerrahi sonrası memnuniyet 'çok iyi' olarak belirlendi. Sonuç: KPEO'lu hastalarda kapak aralığının hastanın yaşam kalitesini...

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Frontalis sling operation using silicone rod for the correction of ptosis in chronic progressive external ophthalmoplegia

Abstract: The frontalis sling operation using silicone rod can safely and effectively correct ptosis in chronic progressive external ophthalmoplegia patients without serious corneal complications.

Cited by 38 publications

References 12 publications

Exposure keratopathy following silicone frontalis suspension in adult neuro‐ and myogenic ptosis

Exposure keratopathy following silicone frontalis suspension in adult neuro‐ and myogenic ptosis

The Neuro-ophthalmology of Mitochondrial Disease

Kronik Progresif Eksternal Oftalmoplejili Hastalarda Pitozis Cerrahisi Sonuçları

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