Abstract
Purpose :
To evaluate the functional and cosmetic outcomes of surgical ptosis repair for mild to moderate ptosis in Marcus Gunn jaw winking phenomenon.
Methods :
After IRB approval was obtained 30 patients were enrolled prospectively over an 18-month period. Ages ranged from 4 to 40 years. All patients had unilateral ptosis with jaw winking phenomenon. Pre-operative measurements of the ptotic eyes included upward jerk of the upper eyelid with jaw movement (average 8 ±2.56 mm). Results were gathered by comparing pre- and post-operative photographs.
Results :
All surgeries were performed under general anesthesia. The levator palpebrae superioris (LPS) was exposed through a posterior eyelid approach. The LPS was released from the superior border of the tarsal plate and from Whitnall’s ligament, followed by a 25 mm LPS resection. A silicone tarsal-frontalis sling was then inserted.
All eyes had improvement in ptosis post-operatively measured by MRD-1 (average pre-operative 0.89±2.42 mm vs post-operative 3.5±0.65mm) and palpebral fissure (average pre-op 6.53 ± 3.50 mm vs 13± 2.5mm). No patients had post-operative upward eyelid flick on jaw movement, lagophthalmos, or recurrence on 6-12 month follow up visits.
Conclusions :
This unilateral surgical approach yielded favorable surgical and cosmetic outcomes in all 30 patients with minimal complications. Its posterior approach is unqiue and spares the patient a lid crease incision. With general anesthesia there was no intraoperative jaw movement required to evaluate LPS fibers.
This is a 2020 ARVO Annual Meeting abstract.