Lower eyelid recession combined with ptosis surgery in patients with poor ocular motility.

Abstract:

BACKGROUND:The authors treated ten patients (13 eyelids) with visually significant blepharoptosis and compromised corneal protective mechanisms resulting from paresis of ocular motility and absent Bell phenomenon. METHODS:Traditional upper eyelid surgery consisting of frontalis suspension (6 eyelids) or levator aponeurosis advancement (7 eyelids) was used. In all patients, the ptosis repair was combined with maximum recession of the lower eyelid, using a posterior lamellar scleral spacer graft. The goal was to maintain a narrow, vertical, interpalpebral fissure to allow for eyelid closure, but to reposition this opening centrally over the pupil. RESULTS:Postoperatively, all patients achieved significant improvement in superior visual field, with no associated keratopathy. Complications were few, minor, and transient. The postoperative cosmetic appearance was acceptable in all patients. CONCLUSIONS:This combined procedure allows repair of fair- to poor-function ptosis in patients in whom ptosis surgery previously has been considered risky. For the authors, this technique has been proven safe and effective and should be considered in any patient population with compromised corneal protective mechanisms.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

Holck DE,Dutton JJ,DeBacker C

doi

10.1016/s0161-6420(97)30356-x

subject

Has Abstract

pub_date

1997-01-01 00:00:00

pages

92-5

issue

1

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(97)30356-X

journal_volume

104

pub_type

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