April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Predictors for Lid Crease Formation After Frontalis Suspension Surgery for Myogenic Ptosis
Author Affiliations & Notes
  • E. S. Hong
    Ophthalmology, University of Iowa, Hospitals and Clinics, Iowa City, Iowa
  • E. Watterberg
    Eye Associates of New Mexico, Albuquerque, New Mexico
  • L. Morrison
    Neurology, University of New Mexico, School of Medicine, Albuquerque, New Mexico
  • K. D. Carter
    Ophthalmology, University of Iowa, Hospitals and Clinics, Iowa City, Iowa
  • R. C. Allen
    Ophthalmology, University of Iowa, Hospitals and Clinics, Iowa City, Iowa
  • Footnotes
    Commercial Relationships  E.S. Hong, None; E. Watterberg, None; L. Morrison, None; K.D. Carter, None; R.C. Allen, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 1471. doi:
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    • Get Citation

      E. S. Hong, E. Watterberg, L. Morrison, K. D. Carter, R. C. Allen; Predictors for Lid Crease Formation After Frontalis Suspension Surgery for Myogenic Ptosis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1471.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To determine which pre-operative and intra-operative factors influence formation of a lid crease after frontalis suspension surgery in patients with myogenic ptosis.

Methods: : This study was a non-randomized, retrospective, comparative case series. Patients were identified from the practice of a single individual (RCA). The study was in compliance with the Declaration of Helsinki. The following data were obtained: patient age; diagnosis; pre-operative margin reflex distance (MRD); palpebral fissure height (PF); and levator function (LF); surgical procedure details; and post-operative MRD. Post-operative photographs were reviewed and the lid creases were graded by two reviewers (RCA and KDC) as poor, fair, or good.

Results: : 41patients (81 eyelids) were identified who underwent frontalis suspension surgery using a silicone sling by a single surgeon. Tarsal fixation of the sling and retro-septal placement of the sling was performed in all surgeries. Mean age at the time of surgery was 62.7 years. 39 patients (95%) had a diagnosis of oculopharyngeal muscular dystrophy (OPMD). Pre-operative mean MRD, PF, and LF were 0.20 mm, 5.1 mm, and 10.9 mm, respectively. Mean follow up was 13 months. Post-operative mean MRD was 2.3 mm. The following factors correlated positively with a good lid crease: levator function, conservative concurrent blepharoplasty, preservation of preaponeurotic fat, and incorporation of the levator aponeurosis into the skin closure.

Conclusions: : The following factors appear to influence favorably towards the formation of a lid crease in patients with myogenic ptosis who underwent frontalis suspension with a silicone frontalis sling: pre-operative levator function, preservation of skin above the lid crease, preservation of pre-aponeurotic fat, and incorporation of the levator aponeurosis into the skin incision/crease closure.

Keywords: eyelid • shape and contour 
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