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Sara Reggie, Salil Kumar Mandal, Suman Lodh, James C. Fleming, Brian Fowler; Surgical outcomes of Marcus Gunn jaw winking ptosis correction: a novel approach. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3967.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the functional and cosmetic outcomes of surgical ptosis repair for mild to moderate ptosis in Marcus Gunn jaw winking phenomenon.
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.
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.
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.
LPS disinsertion from Whitnall's ligament and tarsal plate followed by LPS resection, by posterior eyelid approach.
Immediate post-op result showing adequate and symmetric eyelid height.
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