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Roberta Lilian Fernandes de Sousa Meneghim, Lucieni Cristina Barbarini Ferraz, Alicia Galindo, Rajiv Khandekar, Silvana Artioli Schellini; Tarsal switch to correct severe neurogenic or myogenic ptosis. Invest. Ophthalmol. Vis. Sci. 2016;57(12):678.
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© ARVO (1962-2015); The Authors (2016-present)
To report the tarsal switch procedure to correct severe neurogenic or myogenic ptosis with poor levator function (< 4mm) and Bell’s phenomenon absent.
Eleven patients (seven male and four female) with myopathic or neurogenic ptosis treated at the Faculty of Medicine of Botucatu – UNESP - Brazil and at King Khaled Eye Specialist Hospital – Riyadh – Saudi Arabia underwent to surgery to correct palpebral ptosis using the tarsal switch procedure between the years 2012 to 2015. Complete eye examination was performed, including margin reflex distance (MRD), palpebral fissure, levator function, extraocular motility and Bell’s phenomenon.
Surgeries were performed in 18 lids of 11 patients. Median age of the patients at the time of the surgery was 57 years (Minimum=29; Maximum=86). Seven (64%) were males and four (36%) females; four had unilateral ptosis and seven, bilateral; nine patients had myogenic and two neurogenic ptosis. All patients showed improvement of head position after surgery. The MRD before surgery was 0 mm and after surgery was 1.0mm, with significance (Wilcoxon p = 0.001). The median of palpebral fissure before surgery was 2 mm and after surgery, 7 mm with significance (Wilcoxon p < 0.001).
Tarsal switch procedure constitutes an efficient alternative proposition to correct severe ptosis with poor levator function and negative Bell’s phenomenon and can be performed decreasing the eye exposure risk.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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