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 st...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(>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.展开更多
Blepharoptosis is a symptom that is commonly observed in clinics.It presents with drooping of the upper eyelid and an asymmetric appearance of the eye.It can occur because of various causes.If left untreated,severe co...Blepharoptosis is a symptom that is commonly observed in clinics.It presents with drooping of the upper eyelid and an asymmetric appearance of the eye.It can occur because of various causes.If left untreated,severe congenital blepharoptosis may impair visual function.The surgical approach largely depends on the severity of blepharoptosis,Bell’s phenomenon,and surgical history.However,it is intricate and difficult to achieve satisfactory symmetry and avoid complications.Owing to the complexity involved and discrepancies in treatment,we planned to arrive at a consensus on the diagnosis and correction of blepharoptosis among Chinese plastic surgeons and ophthalmologists,aiming to establish more standardized treatments and cause less harm to patients.展开更多
Purpose: To investigate the etiology and the treatment of acquired blepharoptosis inpatients,.especially secondary to surgery.Methods: The clinical records of 65 consecutive patients with acquired ptosis were reviewed...Purpose: To investigate the etiology and the treatment of acquired blepharoptosis inpatients,.especially secondary to surgery.Methods: The clinical records of 65 consecutive patients with acquired ptosis were reviewed from an eye center and a comprehensive hospital..Potential factors responsible for acquired ptosis were investigated..Surgical management principles and post-operative exposure keratitis are discussed.Results:.The top three causes of acquired ptosis were postsurgical ptosis(20 / 65, 30.8%), traumatic ptosis(17 / 65,26.2%) and senile aponeurotic ptosis(12 / 65, 18.5%). Twenty patients had post-surgical ptosis secondary to orbital surgery(8 / 20, 40.0%), enucleation and hydroxyapatite(HA) artificial eye implantation(4 / 20, 20%), eyelid surgery(3 / 20,15%), cataract or glaucoma surgery(2 / 20, 10%), conjunctive surgery(2 / 20, 10%).and superior oblique muscle surgery(1 / 20, 5%). The levator palpebrae superioris(LPS) muscle of ten eyes(10 / 20, 50%) was found during exploration and reattached to the tarsal plate, with shortening of the LPS. Nine eyes(9 / 20, 45%) underwent a frontalis suspension(FS) operation because the LPS muscle was missing. One(1 / 20, 5%)patient was not operated on due to a poor Bell's phenomenon.Two patients(2 / 65, 3.1%)—one patient with post-surgical ptosis and another with aponeurotic ptosis—developed exposure keratitis after ptosis correction.Conclusion: Post-surgical ptosis is one of the most common causes of acquired ptosis. It is important to explore LPS muscle during surgery. LPS reattachment is performed if the muscle is found; otherwise, a FS operation is chosen. Exposure keratitis after correction should be monitored.展开更多
Purpose:.To evaluate the surgical effect of levator muscle shortening and levator aponeurosis tucking in treating minimal and moderate congenital blepharoptosis.Methods:.Clinical data of 28 patients(40 eyes) diagnosed...Purpose:.To evaluate the surgical effect of levator muscle shortening and levator aponeurosis tucking in treating minimal and moderate congenital blepharoptosis.Methods:.Clinical data of 28 patients(40 eyes) diagnosed with mide and moderate congenital blepharoptosis at our institution were retrospectively analyzed. Postoperative efficacy was evaluated and statistically compared between these two techniques.Results:.During 14 months follow-up,.16 eyes with ptosis undergoing levator muscle shortening were treated,.3 with undercorrection of ptosis and 1 with overcorrection of ptosis.In patients receiving levator aponeurosis tucking,.16 eyes were cured and 4 with undercorrection of ptosis.Conclusion:.Both levator muscle shortening and levator aponeurosis tucking are safe and efficacious for correcting minimal and moderate congenital blepharoptosis.展开更多
Background Congenital blepharoptosis(CBP)may be part of a large spectrum of birth defects presenting with other ocular or systemic conditions.Therefore,the aim of the study was to investigate the incidence of congenit...Background Congenital blepharoptosis(CBP)may be part of a large spectrum of birth defects presenting with other ocular or systemic conditions.Therefore,the aim of the study was to investigate the incidence of congenital heart diseases(CHD)in CBP children not associated with specific syndromes.Methods A total of 1053 Chinese children diagnosed with non-syndromic CBP were consecutively enrolled and their cardiac structure was evaluated by echocardiography.Results Forty children were identified with CHD.Twenty-four children had one type of structural malformation(simple CHD).Sixteen children had two or more types of structural malformation(complex CHD).CHD and complex CHD were more prevalent in patients with severe or bilateral ptosis.Multivariate analysis revealed that presence of severe ptosis and bilateral ptosis was independently associated with CHD occurrence.Conclusions We found an increased frequency of CHD in CBP children,suggesting a clinical need for routine echocardiography evaluation in CBP,especially in children with severe or bilateral ptosis.展开更多
基金Supported by Tianjin Key Medical Discipline Construction Project(No.TJYXZDXK-016A).
文摘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(>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.
文摘Blepharoptosis is a symptom that is commonly observed in clinics.It presents with drooping of the upper eyelid and an asymmetric appearance of the eye.It can occur because of various causes.If left untreated,severe congenital blepharoptosis may impair visual function.The surgical approach largely depends on the severity of blepharoptosis,Bell’s phenomenon,and surgical history.However,it is intricate and difficult to achieve satisfactory symmetry and avoid complications.Owing to the complexity involved and discrepancies in treatment,we planned to arrive at a consensus on the diagnosis and correction of blepharoptosis among Chinese plastic surgeons and ophthalmologists,aiming to establish more standardized treatments and cause less harm to patients.
基金Key Projects in Science and Technology Development from Guangzhou,China(No.11BppZXaa2060017)
文摘Purpose: To investigate the etiology and the treatment of acquired blepharoptosis inpatients,.especially secondary to surgery.Methods: The clinical records of 65 consecutive patients with acquired ptosis were reviewed from an eye center and a comprehensive hospital..Potential factors responsible for acquired ptosis were investigated..Surgical management principles and post-operative exposure keratitis are discussed.Results:.The top three causes of acquired ptosis were postsurgical ptosis(20 / 65, 30.8%), traumatic ptosis(17 / 65,26.2%) and senile aponeurotic ptosis(12 / 65, 18.5%). Twenty patients had post-surgical ptosis secondary to orbital surgery(8 / 20, 40.0%), enucleation and hydroxyapatite(HA) artificial eye implantation(4 / 20, 20%), eyelid surgery(3 / 20,15%), cataract or glaucoma surgery(2 / 20, 10%), conjunctive surgery(2 / 20, 10%).and superior oblique muscle surgery(1 / 20, 5%). The levator palpebrae superioris(LPS) muscle of ten eyes(10 / 20, 50%) was found during exploration and reattached to the tarsal plate, with shortening of the LPS. Nine eyes(9 / 20, 45%) underwent a frontalis suspension(FS) operation because the LPS muscle was missing. One(1 / 20, 5%)patient was not operated on due to a poor Bell's phenomenon.Two patients(2 / 65, 3.1%)—one patient with post-surgical ptosis and another with aponeurotic ptosis—developed exposure keratitis after ptosis correction.Conclusion: Post-surgical ptosis is one of the most common causes of acquired ptosis. It is important to explore LPS muscle during surgery. LPS reattachment is performed if the muscle is found; otherwise, a FS operation is chosen. Exposure keratitis after correction should be monitored.
文摘Purpose:.To evaluate the surgical effect of levator muscle shortening and levator aponeurosis tucking in treating minimal and moderate congenital blepharoptosis.Methods:.Clinical data of 28 patients(40 eyes) diagnosed with mide and moderate congenital blepharoptosis at our institution were retrospectively analyzed. Postoperative efficacy was evaluated and statistically compared between these two techniques.Results:.During 14 months follow-up,.16 eyes with ptosis undergoing levator muscle shortening were treated,.3 with undercorrection of ptosis and 1 with overcorrection of ptosis.In patients receiving levator aponeurosis tucking,.16 eyes were cured and 4 with undercorrection of ptosis.Conclusion:.Both levator muscle shortening and levator aponeurosis tucking are safe and efficacious for correcting minimal and moderate congenital blepharoptosis.
基金This work was supported by the National Natural Science Foundation of China grant(Grant no.81570037)the MDT Program of Shanghai Ninth People’s Hospital(Grant no.2017-1-015).
文摘Background Congenital blepharoptosis(CBP)may be part of a large spectrum of birth defects presenting with other ocular or systemic conditions.Therefore,the aim of the study was to investigate the incidence of congenital heart diseases(CHD)in CBP children not associated with specific syndromes.Methods A total of 1053 Chinese children diagnosed with non-syndromic CBP were consecutively enrolled and their cardiac structure was evaluated by echocardiography.Results Forty children were identified with CHD.Twenty-four children had one type of structural malformation(simple CHD).Sixteen children had two or more types of structural malformation(complex CHD).CHD and complex CHD were more prevalent in patients with severe or bilateral ptosis.Multivariate analysis revealed that presence of severe ptosis and bilateral ptosis was independently associated with CHD occurrence.Conclusions We found an increased frequency of CHD in CBP children,suggesting a clinical need for routine echocardiography evaluation in CBP,especially in children with severe or bilateral ptosis.
