Research on the expression of elastin in the conjoint fascial sheath for the correction of severe unilateral congenital blepharoptosis

Liu, Zhaochuan; Jia, Xin; Pang, Runhui; Wang, Huixing; Shi, Junhu; Bai, Péter

doi:10.1186/s12886-022-02469-w

Cited by 4 publications

(10 citation statements)

References 19 publications

(26 reference statements)

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“…Recent research has confirmed that the CFS is rich in collagen fibers and elastic fibers (11). Additionally, our previous study confirmed that the CFS and LM are rich in elastic fibers and elastin in pediatric patients, and CFS-based suspension is effective to cure severe congenital blepharoptosis in pediatric patients (9). In the present study, we performed CFS + LM suspension to treat severe congenital blepharoptosis in pediatric patients in different age groups and evaluated the efficacy and safety of this procedure.…”

Section: Introductionmentioning

confidence: 54%

“…This procedure has a satisfactory curative effect in mild or moderate blepharoptosis, however, the effect of the surgery on severe ptosis was not ideal (6,7). Over the past few years, CFS + LM complex suspension, a modified CFS-based surgery, has shown good results for the treatment of severe blepharoptosis (7)(8)(9). Many anatomical and histological studies have also provided helpful information (9,10).…”

Section: Introductionmentioning

confidence: 99%

“…Over the past few years, CFS + LM complex suspension, a modified CFS-based surgery, has shown good results for the treatment of severe blepharoptosis (7)(8)(9). Many anatomical and histological studies have also provided helpful information (9,10). Recent research has confirmed that the CFS is rich in collagen fibers and elastic fibers (11).…”

Section: Introductionmentioning

confidence: 99%

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Modified conjoint fascial sheath suspension for the correction of severe congenital blepharoptosis in pediatric patients at different ages

Wang

Liu²,

Li³

et al. 2022

Front. Pediatr.

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ObjectiveTo evaluate the surgical outcomes of modified combined fascia sheath (CFS) and levator muscle (LM) complex suspension for the correction of severe congenital blepharoptosis in pediatric patients.MethodsPediatric patients with severe congenital blepharoptosis were enrolled form July 2017 to July 2021. All patients were divided into two groups according to their age (group A ≤ 7 years; group B > 7 years) and received CFS + LM suspension surgery. Main surgical outcome indexes include margin reflex distance 1 (MRD1) and MRD1 regression. Postoperative complications such as lagophthalmos (LAG), conjunctival prolapse, exposure keratopathy and trichiasis were documented.ResultsFifty patients (60 eyes) were enrolled, including 17 patients (18 eyes) in group A and 33 patients (42 eyes) in group B. The MRD1 in group A was 3.06 ± 0.64 mm at 6 months after the operation, and the MRD1 in group B was 2.64 ± 0.69 mm 6 months postoperatively which is significantly lower than that of group A (P = 0. 044). At the last visit, however, the MRD1 in group A was 3.00 ± 0.69 mm and the MRD1 in group B was 2.64 ± 0.70 mm. There was no significant difference in MRD1 between two groups in long term (P = 0.255). Additionally, there were a variety of degrees of MRD1 regression, especially in the first month after the operation in both groups (both P < 0.001). Moreover, there were 9 cases of postoperative complications in group A and 13 cases in group B. The overall occurrence of postoperative complications in group A was significantly lower than that in groups B (χ2 = 4.413, P = 0.036).ConclusionsCFS + LM suspension, a modified CFS-based surgery, is an effective treatment for severe congenital blepharoptosis in pediatric patients. Moreover, CFS + LM suspension demonstrate excellent long-term outcomes, including good movement of the eyelid, satisfied eyelid closure and fewer postoperative complications.

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Section: Introductionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Modified conjoint fascial sheath suspension for the correction of severe congenital blepharoptosis in pediatric patients at different ages

Wang

Liu²,

Li³

et al. 2022

Front. Pediatr.

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“…Clinically, the grade classification of ptosis depends on LM strength, and doctors also determine the method of surgery based on the LM strength ( 1 ). Therefore, the present study followed up on a previous study ( 8 ) and continued to investigate the association between elastin expression and LM strength.…”

Section: Introductionmentioning

confidence: 99%

Elastin expression in the conjoint fascial sheath and levator palpebrae superioris muscle of children with unilateral severe congenital ptosis with different muscle strengths

Jia,

Liu,

Shi

et al. 2024

Exp Ther Med

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Elastin expression in the conjoint facial sheath (CFS) of patients of different ages with severe ptosis has been extensively studied, but its expression in the CFS of pediatric patients with severe ptosis with different muscle strengths remains poorly understood. The aim of the present study was to investigate the expression of elastin in the CFS and levator palpebrae superioris muscle (LM) of children with severe congenital ptosis with different LM strengths. In total, 20 pediatric patients with unilateral severe congenital ptosis (20 eyes) were included, who underwent CFS + LM complex suspension surgery from June 2020 to February 2022. Among these patients, the LM strength was 0-1 mm in 10 patients and 2-3 mm in the other 10 patients. Excess CFS and LM tissue samples were obtained from the patients during surgery, before the protein expression levels of elastin in the specimens were measured by western blotting. During the 6-month postoperative follow-up period, the good correction rate, the degree of incomplete eyelid closure and the incidence of complications were observed. Western blotting results showed that, compared with that in the 0-1 mm group, elastin expression was not significantly different in the CFS, whereas it was significantly increased (P=0.021) in the LM of the 2-3 mm group. In addition, elastin expression in the CFS was markedly higher compared with that in the LM in both groups (in the 0-1 mm group, P=0.005; in the 2-3 mm group, P=0.009). Additionally, the curative effect evaluation revealed that the good correction rates in the 0-1 and 2-3 mm groups were 90 and 100%, respectively. In total, 3 patients experienced conjunctival prolapse during the follow-up period, including 2 patients in the 0-1 mm group and 1 patient in the 2-3 mm group, but there were no other complications. To conclude, elastin expression in the CFS was found to be higher compared with that in the LM of children with severe congenital ptosis. Although elastin expression in the LM was positively associated with LM strength, its expression in the CFS displayed no clear association with LM function. Therefore, these observations suggested that CFS + LM complex suspension surgery is viable to correct severe congenital ptosis in pediatric patients.

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“…7 Recently, a modified surgery known as CFS + LM complex suspension has exhibited positive outcomes in correcting severe ptosis. [6][7][8][9][10] However, CFS + LM surgery for simple severe congenital ptosis in children is Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (www.op-rs.com).…”

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confidence: 99%

Modified Conjoint Fascial Sheath and Levator Muscle Complex Suspension for the Correction of Simple Severe Congenital Ptosis in Pediatrics and the Effect on Refractive Status

Li,

Yu,

Wang

et al. 2024

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: To evaluate the outcomes of modified combined fascia sheath and levator muscle complex suspension to correct severe congenital ptosis in pediatrics and the effect on refractive status. Methods: This prospective, case series study enrolled patients (aged ≤18 years) with simple severe congenital ptosis at Zhongshan Ophthalmic Center. All patients were treated with combined fascia sheath + levator muscle suspension and followed up for 3 months. Preoperative and postoperative cycloplegic refraction and the best-corrected visual acuity were performed. The types of astigmatism include with-the-rule, against-the-rule, and oblique. Results: Thirty-six patients (50 eyes) were enrolled. The mean age was 7.11 ± 3.72 years. The surgery success rate was 90.0%. Following surgery, the eyelid contour of all eyes exhibited natural symmetry and satisfactory curvature. The eyelid height difference in OUs was ≤1 mm for 42 eyes. For 47 eyes, the eyelid crease was symmetry. Two eyes had conjunctival prolapse, and 1 eye developed trichiasis. After surgery, cylinder power changed from mean −1.14 ± 1.27 D to −1.54 ± 1.25 D (p < 0.001) and best-corrected visual acuity improved from mean 0.205 ± 0.217 logarithm of the minimum angle of resolution to 0.168 ± 0.176 logarithm of the minimum angle of resolution (p = 0.048). The quantities of with-the-rule increased from 35 eyes to 41 eyes, oblique from 4 eyes to 6 eyes, while against-the-rule decreased from 11 eyes to 3 eyes (p = 0.01). Conclusions: Combined fascia sheath + levator muscle suspension under general anesthesia is effective and safe for severe congenital ptosis in pediatrics. However, astigmatism increased and the types of astigmatism changed after surgery.

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Research on the expression of elastin in the conjoint fascial sheath for the correction of severe unilateral congenital blepharoptosis

Cited by 4 publications

References 19 publications

Modified conjoint fascial sheath suspension for the correction of severe congenital blepharoptosis in pediatric patients at different ages

Modified conjoint fascial sheath suspension for the correction of severe congenital blepharoptosis in pediatric patients at different ages

Elastin expression in the conjoint fascial sheath and levator palpebrae superioris muscle of children with unilateral severe congenital ptosis with different muscle strengths

Modified Conjoint Fascial Sheath and Levator Muscle Complex Suspension for the Correction of Simple Severe Congenital Ptosis in Pediatrics and the Effect on Refractive Status

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