[Retracted] Treatment of Severe Ptosis by Conjoint Fascial Sheath Suspension

Sang, Pengfei; Fang, Mingsong; Li, Xuan; Liu, Chang; Xi, Qingchun

doi:10.1155/2021/1837458

Cited by 9 publications

(11 citation statements)

References 26 publications

(18 reference statements)

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“…The mean MRD1 of group A at the last visit was 3.00 ± 0.69 mm, which approximates the result of 3.10 ± 0.22 (22). The corrective effect was 77.78% at the last visit in group A, which is better than the result of 67.92% in a previous report (23). In view of the long-term outcomes after the operation, there was no significant difference between group A and group B.…”

Section: Discussionsupporting

confidence: 44%

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: Discussionsupporting

confidence: 44%

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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“…Histologically, CFS is composed of thick collagen bundle and confluent elastic fibers without any smooth muscles. Due to its tough nature, it has been used successfully in open, anterior approach of blepharoptosis surgery [7][8][9][10][11] . In this research, we have further developed this technique and used the CFS as a fixation point from which to suspend the tarsus using sutures.…”

Section: Introductionmentioning

confidence: 99%

Symmetry of upper eyelid after unilateral blepharoptosis repair with minimally invasive conjoint fascial sheath suspension technique

Liu,

Chen

2024

Int J Ophthalmol

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AIM: To investigate the symmetry of upper eyelid in patients with unilateral mild and moderate blepharoptosis who underwent unilateral minimally invasive combined fascia sheath (CFS) suspension. METHODS: A retrospective study of patients who underwent unilateral minimally invasive CFS suspension surgery between January 2018 and December 2021. Inclusion criteria included unilateral mild and moderate ptosis, good levator muscle function (&#x003E;9 mm) and follow-up of at least 6mo. Pre- and post-operative symmetry was graded subjectively for marginal reflex distance 1 (MRD1), tarsal platform show (TPS) and eyebrow fat span (BFS). A t-test was used to evaluate MRD1, TPS and BFS asymmetry by calculating delta values. The Bézier curve tool of the Image J software was used to extract the upper eyelid contours, where the symmetry was measured by the percentage of overlapping curvatures (POC). RESULTS: Totally 105 patients (105 eyelids) were included (mild group, n=84; moderate group, n=21). Postoperatively, all patients increased MRD1 and decreased TPS in the ptotic eye while maintaining unchanged BFS. The asymmetric delta value for MRD1 was measured to be 1.48±0.86 preoperatively, and it decreased to 0.58±0.67 postoperatively in all cases (P=0.0004). In patients with mild ptosis, the asymmetry value of TPS fell significantly from 1.15±0.62 to 0.68±0.38 (P=0.0187). The symmetry of the upper eyelid contour increased in all subgroups of patients, with a POC of 59.39%±13.45% preoperatively and POC of 78.29%±13.80% postoperatively. CONCLUSION: Minimally invasive CFS suspension is proved to be an effective means of improving the symmetry of unilateral ptosis in terms of MRD1 (all subgroups), POC (all subgroups) and TPS (only mild group), whereas BFS is unaffected.

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“…Since 2002, CFS suspension surgery has been used to correct ptosis ( 3 ). In CFS surgery, the CFS is fixed at the anterior one-third of the tarsus so that the upper eyelid margin of the affected eye is located at the upper edge of the cornea when looking straight ahead in a sitting position to serve as a corrective role ( 4 ). This surgery is now recognized in clinical practice due to good efficacy and a low number of complications, such as lagophthalmos, exposure conjunctivitis and hematoma in the eyebrow area ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

“…This surgery is now recognized in clinical practice due to good efficacy and a low number of complications, such as lagophthalmos, exposure conjunctivitis and hematoma in the eyebrow area ( 5 ). However, a number of patients experience upper eyelid retraction after surgery, and Sang et al ( 4 ) reported that the amount of upper eyelid retraction was 0.21±0.07 mm 3 months after surgery. CFS suspension alone lacks strong attachment points, so it cannot maintain long-term tissue tension.…”

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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[Retracted] Treatment of Severe Ptosis by Conjoint Fascial Sheath Suspension

Cited by 9 publications

References 26 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

Symmetry of upper eyelid after unilateral blepharoptosis repair with minimally invasive conjoint fascial sheath suspension technique

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

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