Severe unilateral congenital ptosis with poor levator function: tarsoconjunctival mullerectomy plus levator resection vs frontalis sling procedure

Abstract

AIM: To compare frontalis sling and tarsoconjunctival mullerectomy plus levator resection (TCMLR) in subjects with severe unilateral congenital ptosis with poor levator function (LF). METHODS: A prospective non-randomized non-blinded single center clinical trial. Fifty patients with severe unilateral congenital ptosis with poor LF were recruited. The frontalis sling and TCMLR were performed and the functional, cosmetic outcomes, complications, and success rate were evaluated at 1, 3, and 6mo postoperatively. The t-test, Chi-square, Fishers exact, and nonparametric Mann-Whitney tests were used by SPSS software. RESULTS: Frontalis sling and TCMLR procedures were performed on 26 and 24 patients respectively. The mean age was 10.97±10.67y. LF was significantly better in the TCMLR group at months 1, 3, and 6 (P=0.002). Lagophthalmos was more common in the TCMLR group (no significant difference). At month 3, mild punctate epithelial erosions were observed more in the frontalis sling group (P=0.002). Significant complete success rate of 1st and 6th month for the frontalis sling vs TCMLR groups were 50% vs 20.8% (P=0.02), and 38.4% vs 50% (P=0.03) respectively. CONCLUSION: Complete success rate of TCMLR is higher in long-term follow-up in contrast with the frontalis sling in the short-term. Transient complications are more detected in mid-term follow-ups in both groups.

A new technique to prevent conjunctival prolapse in Asian patients for correcting severe blepharoptosis

“…Over time, this condition can lead to other issues such as strabismus, amblyopia, head tilting and forehead lifting, and even spinal deformity and scoliosis [ 6 , 7 ]. According to the literature, the incidence of amblyopia is approximately 2.8% ~ 3.2%.Among patients with ptosis, the incidence of amblyopia ranges from 23.9% to 56%, and the risk increases with the severity of ptosis [ 7 – 9 ].…”

Lower eyelid position after ptosis repair in patients with blepharoptosis

“…It is among the common neuromuscular disorders observed in patients attending ophthalmology clinics and can lead to physical complications such as amblyopia and ocular deviation, as well as psychological consequences. [1][2][3] The incidence rate of ptosis is reported to be 7.9 per 100 000 individuals younger than 19 years. 4 Blepharoptosis can occur unilaterally or bilaterally and may be classified as either congenital or acquired.…”

“…Blepharoptosis is a condition characterized by the abnormal lower position of one or both upper eyelids. It is among the common neuromuscular disorders observed in patients attending ophthalmology clinics and can lead to physical complications such as amblyopia and ocular deviation, as well as psychological consequences 1–3 . The incidence rate of ptosis is reported to be 7.9 per 100 000 individuals younger than 19 years 4 .…”