Research Article
BibTex RIS Cite

Outcomes of Maximal Levator Resection Procedure in Cases of Congenital Myogenic Ptosis

Year 2019, Volume: 46 Issue: 3, 535 - 542, 16.09.2019
https://doi.org/10.5798/dicletip.620581

Abstract

Objective: This study aimed to evaluate the outcomes of maximal levator resection in cases of congenital myogenic ptosis with poor levator function.
Method: Thirty-threeptotic eyelids of 30 cases undergoing maximal levator resection were retrospectively included. There were 18 male and 12 female cases. The mean age of the cases was 12.55±5.3 years (range, 4-26 years). For all eyes, vertical palpebral aperture, margin reflex distance, levator functions, and upper eyelid crease height were measured. Ptosisseverity was “mild” when the eyelid elevation was ≤2 mm; “moderate” when the eyelid elevation was 3 mm; and “severe” when the eyelid elevation was ≥4 mm. The mean age of the cases (18 males and 12 females) was 12.55±5.3 years (range, 4-26 years).
Results and Conclusion: The mean ptosis severity (vertical palpebral aperture) was 5.136 mm preoperatively and 0.818 mm at the postoperative Month 3 (p<0.001). Surgical outcomes were successful in 26 eyes (78%), satisfactory in 4 eyes (12%), and unsuccessful in 3 eyes (9%).Conclusively, successful outcomes were obtained after maximal levator resection in ptosis cases with poor levator functionin most of casses.

References

  • 1. Gautam P, Adhikari R, Sharma BR. Etiopathogenetic patterns of blepharoptosis in Western Nepal: an Overview. Nepal J Ophthalmol. 2016; 8: 36-40.
  • 2. Soo Hoo JR, Davies BW, Allard FD, Durairaj VD. Congenital ptosis. Surv Ophthalmol. 2014; 59: 483-92.
  • 3. Finsterer J. Ptosis: causes, presentation, and management.Aesthetic Plast Surg. 2003; 27: 193-204.
  • 4. Marenco M, Macchi I, Macchi I, et all. Clinical presentation and management of congenital ptosis. Clin Ophthalmol. 2017; 11: 453-63.
  • 5. Gazzola R, Piozzi E, Vaienti L, Wilhelm BaruffaldiPreis F. Therapeutic algorithm for congenital ptosis repair with levator resection and frontalis suspension: results and literature review. SeminOphthalmol. 2018; 33: 454-60.
  • 6. Mete A, Cagatay HH, Pamukcu C, et all. Maximal levator muscle resection for primary congenital blepharoptosis with poor levator function. Semin Ophthalmol. 2017; 32: 270-75.
  • 7. Goel R, Kishore D, Nagpal S, Jain S, Agarwal T. The relationship of amount of resection and time for recovery of Bell's phenomenon after levator resection in congenital ptosis. Open Ophthalmol J. 2017; 11: 24-30.
  • 8. Bernardini FP, de Conciliis C, Devoto MH. Frontalis suspension sling using a silicone rod in patients affected by myogenic blepharoptosis. Orbit. 2002; 21: 195-8.
  • 9. Lee JH, Kim YD. Surgical treatment of unilateral severe simple congenital ptosis. Taiwan J Ophthalmol. 2018; 8: 3-8.
  • 10. Lee JH, Aryasit O, Kim YD, Woo KI, Lee L, Johnson ON 3rd. Maximal levator resection in unilateral congenital ptosis with poor levator function. Br J Ophthalmol. 2017; 101: 740-46.
  • 11. Berke RN, Wadsworth JA. Histology of levator muscle in congenital and acquired ptosis. AMA Arch Ophthalmol. 1955; 53: 413-28.
  • 12. Collin JR. New concepts in the management of ptosis.Eye (Lond). 1988; 2: 185-8.
  • 13. Ünal M. Levator aponeurosis surgery.T Klin J Ophthalmol. 1997; 6: 98-105.
  • 14. Smith B, McCord CD, Baylis H. Surgical treatment of blepharoptosis. Am J Ophthalmol. 1969; 68: 92-9.
  • 15. Shore JW, Bergin DJ, Garrett SN. Results of blepharoptosis surgery with early postoperative adjustment. Ophthalmology. 1990; 97: 1502-11.
  • 16. Press UP, Hübner H. Maximal levator resection in the treatment of unilateral congenital ptosis with poor levator function.Orbit. 2001; 20: 125-9.
  • 17. Innocenti A, Mori F, Melita D, Dreassi E, Ciancio F, Innocenti M. Evaluation of long-term outcomes of correction of severe blepharoptosis with advancement of external levator muscle complex: descriptive statistical analysis of the results. In Vivo. 2017; 31: 111-5.
  • 18. Nguyen CT, Hardy TG. Levator resection for congenital ptosis: Does pre-operative levator function or degree of ptosis affect successful outcome? Orbit. 2017; 36: 325-30.
  • 19. Sar R, Yousuf S, Gupta Y. Surgical management of congenital and aponeurotic ptosis – cosmetic outcome. Austin J Clin Ophthalmol. 2014; 1: 1035.
  • 20. Wu SY, Ma L, Huang HH, Tsai YJ. Analysis of visual outcomes and complications following levator resection for unilateral congenital blepharoptosis without strabismus. Biomed J. 2013; 36: 179-87.
  • 21. Abrishami A, Bagheri A, Salour H, Aletaha M, Yazdani S. Outcomes of levator resection at tertiary eye care center in Iran: a 10-year experience. Korean J Ophthalmol. 2012; 26: 1-5.
  • 22. Şimşek EB, Parlakgüneş S. Results of conjunctiva Müller’s muscle resection and external levator resection techniques for ptosis repair ptosis and results of treatment options. OpthClinTher.2018; 2: 9.
Year 2019, Volume: 46 Issue: 3, 535 - 542, 16.09.2019
https://doi.org/10.5798/dicletip.620581

Abstract

References

  • 1. Gautam P, Adhikari R, Sharma BR. Etiopathogenetic patterns of blepharoptosis in Western Nepal: an Overview. Nepal J Ophthalmol. 2016; 8: 36-40.
  • 2. Soo Hoo JR, Davies BW, Allard FD, Durairaj VD. Congenital ptosis. Surv Ophthalmol. 2014; 59: 483-92.
  • 3. Finsterer J. Ptosis: causes, presentation, and management.Aesthetic Plast Surg. 2003; 27: 193-204.
  • 4. Marenco M, Macchi I, Macchi I, et all. Clinical presentation and management of congenital ptosis. Clin Ophthalmol. 2017; 11: 453-63.
  • 5. Gazzola R, Piozzi E, Vaienti L, Wilhelm BaruffaldiPreis F. Therapeutic algorithm for congenital ptosis repair with levator resection and frontalis suspension: results and literature review. SeminOphthalmol. 2018; 33: 454-60.
  • 6. Mete A, Cagatay HH, Pamukcu C, et all. Maximal levator muscle resection for primary congenital blepharoptosis with poor levator function. Semin Ophthalmol. 2017; 32: 270-75.
  • 7. Goel R, Kishore D, Nagpal S, Jain S, Agarwal T. The relationship of amount of resection and time for recovery of Bell's phenomenon after levator resection in congenital ptosis. Open Ophthalmol J. 2017; 11: 24-30.
  • 8. Bernardini FP, de Conciliis C, Devoto MH. Frontalis suspension sling using a silicone rod in patients affected by myogenic blepharoptosis. Orbit. 2002; 21: 195-8.
  • 9. Lee JH, Kim YD. Surgical treatment of unilateral severe simple congenital ptosis. Taiwan J Ophthalmol. 2018; 8: 3-8.
  • 10. Lee JH, Aryasit O, Kim YD, Woo KI, Lee L, Johnson ON 3rd. Maximal levator resection in unilateral congenital ptosis with poor levator function. Br J Ophthalmol. 2017; 101: 740-46.
  • 11. Berke RN, Wadsworth JA. Histology of levator muscle in congenital and acquired ptosis. AMA Arch Ophthalmol. 1955; 53: 413-28.
  • 12. Collin JR. New concepts in the management of ptosis.Eye (Lond). 1988; 2: 185-8.
  • 13. Ünal M. Levator aponeurosis surgery.T Klin J Ophthalmol. 1997; 6: 98-105.
  • 14. Smith B, McCord CD, Baylis H. Surgical treatment of blepharoptosis. Am J Ophthalmol. 1969; 68: 92-9.
  • 15. Shore JW, Bergin DJ, Garrett SN. Results of blepharoptosis surgery with early postoperative adjustment. Ophthalmology. 1990; 97: 1502-11.
  • 16. Press UP, Hübner H. Maximal levator resection in the treatment of unilateral congenital ptosis with poor levator function.Orbit. 2001; 20: 125-9.
  • 17. Innocenti A, Mori F, Melita D, Dreassi E, Ciancio F, Innocenti M. Evaluation of long-term outcomes of correction of severe blepharoptosis with advancement of external levator muscle complex: descriptive statistical analysis of the results. In Vivo. 2017; 31: 111-5.
  • 18. Nguyen CT, Hardy TG. Levator resection for congenital ptosis: Does pre-operative levator function or degree of ptosis affect successful outcome? Orbit. 2017; 36: 325-30.
  • 19. Sar R, Yousuf S, Gupta Y. Surgical management of congenital and aponeurotic ptosis – cosmetic outcome. Austin J Clin Ophthalmol. 2014; 1: 1035.
  • 20. Wu SY, Ma L, Huang HH, Tsai YJ. Analysis of visual outcomes and complications following levator resection for unilateral congenital blepharoptosis without strabismus. Biomed J. 2013; 36: 179-87.
  • 21. Abrishami A, Bagheri A, Salour H, Aletaha M, Yazdani S. Outcomes of levator resection at tertiary eye care center in Iran: a 10-year experience. Korean J Ophthalmol. 2012; 26: 1-5.
  • 22. Şimşek EB, Parlakgüneş S. Results of conjunctiva Müller’s muscle resection and external levator resection techniques for ptosis repair ptosis and results of treatment options. OpthClinTher.2018; 2: 9.
There are 22 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Articles
Authors

Selahattin Balsak 0000-0002-2269-474X

Umut Dağ This is me 0000-0002-7866-7898

Yakup Güneş This is me 0000-0002-4745-0717

Sevim Çakmak This is me 0000-0002-3199-7224

Uğur Keklikçi This is me 0000-0003-2348-4856

Publication Date September 16, 2019
Submission Date May 27, 2019
Published in Issue Year 2019 Volume: 46 Issue: 3

Cite

APA Balsak, S., Dağ, U., Güneş, Y., Çakmak, S., et al. (2019). Outcomes of Maximal Levator Resection Procedure in Cases of Congenital Myogenic Ptosis. Dicle Tıp Dergisi, 46(3), 535-542. https://doi.org/10.5798/dicletip.620581
AMA Balsak S, Dağ U, Güneş Y, Çakmak S, Keklikçi U. Outcomes of Maximal Levator Resection Procedure in Cases of Congenital Myogenic Ptosis. diclemedj. September 2019;46(3):535-542. doi:10.5798/dicletip.620581
Chicago Balsak, Selahattin, Umut Dağ, Yakup Güneş, Sevim Çakmak, and Uğur Keklikçi. “Outcomes of Maximal Levator Resection Procedure in Cases of Congenital Myogenic Ptosis”. Dicle Tıp Dergisi 46, no. 3 (September 2019): 535-42. https://doi.org/10.5798/dicletip.620581.
EndNote Balsak S, Dağ U, Güneş Y, Çakmak S, Keklikçi U (September 1, 2019) Outcomes of Maximal Levator Resection Procedure in Cases of Congenital Myogenic Ptosis. Dicle Tıp Dergisi 46 3 535–542.
IEEE S. Balsak, U. Dağ, Y. Güneş, S. Çakmak, and U. Keklikçi, “Outcomes of Maximal Levator Resection Procedure in Cases of Congenital Myogenic Ptosis”, diclemedj, vol. 46, no. 3, pp. 535–542, 2019, doi: 10.5798/dicletip.620581.
ISNAD Balsak, Selahattin et al. “Outcomes of Maximal Levator Resection Procedure in Cases of Congenital Myogenic Ptosis”. Dicle Tıp Dergisi 46/3 (September 2019), 535-542. https://doi.org/10.5798/dicletip.620581.
JAMA Balsak S, Dağ U, Güneş Y, Çakmak S, Keklikçi U. Outcomes of Maximal Levator Resection Procedure in Cases of Congenital Myogenic Ptosis. diclemedj. 2019;46:535–542.
MLA Balsak, Selahattin et al. “Outcomes of Maximal Levator Resection Procedure in Cases of Congenital Myogenic Ptosis”. Dicle Tıp Dergisi, vol. 46, no. 3, 2019, pp. 535-42, doi:10.5798/dicletip.620581.
Vancouver Balsak S, Dağ U, Güneş Y, Çakmak S, Keklikçi U. Outcomes of Maximal Levator Resection Procedure in Cases of Congenital Myogenic Ptosis. diclemedj. 2019;46(3):535-42.