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Lagophthalmos after congenital ptosis surgery: comparison between maximal levator resection and frontalis sling operation.
Eye (Lond). 2020 Jul 10 [Online ahead of print]E

Abstract

BACKGROUND/OBJECTIVES

To compare postoperative lagophthalmos after maximal levator resection (MLR) and frontalis suspension (FS) in congenital ptosis patients with poor levator function (LF).

METHODS

A cross-sectional study was performed to compare postoperative outcomes in patients with preoperative LF ≤ 4 mm who had undergone MLR or FS at a single tertiary institution, and who had visited the outpatient clinic between February 2017 and August 2018. Main outcome measures were as follows: (1) Preoperative LF and margin reflex distance 1 (MRD1), (2) Postoperative MRD1, lagophthalmos and grade of superficial punctate keratopathy (SPK).

RESULTS

Our study comprised 152 eyelids of 122 patients. There were 71 eyelids in the MLR group and 81 eyelids in the FS group. The MLR group had comparable mean postoperative MRD1 (2.8 ± 0.8 mm) to the FS with autogenous fascia lata (AFL) group (3.0 ± 0.7 mm), while the FS with preserved fascia lata (PFL) group had the lowest mean postoperative MRD1 (2.2 ± 1.0 mm). The PFL group had significantly less lagophthalmos (0.6 ± 1.0 mm) than the AFL (1.9 ± 1.4 mm) and maximal levator resection (1.9 ± 1.7 mm) groups. In the MLR group, there was no significant difference in postoperative surgical measurements between the LF 0-2 mm group and LF 2.5-4 mm group in terms of exposure keratopathy, degree of lagophthalmos and MRD1.

CONCLUSION

MLR is an effective alternative to FS in congenital ptosis patients with poor levator function, with the risk of postoperative lagophthalmos related to postoperative MRD1 rather than preoperative LF.

Authors+Show Affiliations

Ophthalmic Plastic and Reconstructive Surgery, Eagle Eye Centre, Singapore, Singapore.Department of Ophthalmology, Osaka Kaisei Hospital, Osaka, Japan.Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. ydkimoph@skku.edu.Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32651544

Citation

Young, Stephanie Ming, et al. "Lagophthalmos After Congenital Ptosis Surgery: Comparison Between Maximal Levator Resection and Frontalis Sling Operation." Eye (London, England), 2020.
Young SM, Imagawa Y, Kim YD, et al. Lagophthalmos after congenital ptosis surgery: comparison between maximal levator resection and frontalis sling operation. Eye (Lond). 2020.
Young, S. M., Imagawa, Y., Kim, Y. D., Park, J. W., Jang, J., & Woo, K. I. (2020). Lagophthalmos after congenital ptosis surgery: comparison between maximal levator resection and frontalis sling operation. Eye (London, England). https://doi.org/10.1038/s41433-020-1081-z
Young SM, et al. Lagophthalmos After Congenital Ptosis Surgery: Comparison Between Maximal Levator Resection and Frontalis Sling Operation. Eye (Lond). 2020 Jul 10; PubMed PMID: 32651544.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lagophthalmos after congenital ptosis surgery: comparison between maximal levator resection and frontalis sling operation. AU - Young,Stephanie Ming, AU - Imagawa,Yukihiro, AU - Kim,Yoon-Duck, AU - Park,Ji Woong, AU - Jang,Jaeho, AU - Woo,Kyung In, Y1 - 2020/07/10/ PY - 2020/06/12/received PY - 2020/06/30/accepted PY - 2020/06/29/revised PY - 2020/7/12/entrez JF - Eye (London, England) JO - Eye (Lond) N2 - BACKGROUND/OBJECTIVES: To compare postoperative lagophthalmos after maximal levator resection (MLR) and frontalis suspension (FS) in congenital ptosis patients with poor levator function (LF). METHODS: A cross-sectional study was performed to compare postoperative outcomes in patients with preoperative LF ≤ 4 mm who had undergone MLR or FS at a single tertiary institution, and who had visited the outpatient clinic between February 2017 and August 2018. Main outcome measures were as follows: (1) Preoperative LF and margin reflex distance 1 (MRD1), (2) Postoperative MRD1, lagophthalmos and grade of superficial punctate keratopathy (SPK). RESULTS: Our study comprised 152 eyelids of 122 patients. There were 71 eyelids in the MLR group and 81 eyelids in the FS group. The MLR group had comparable mean postoperative MRD1 (2.8 ± 0.8 mm) to the FS with autogenous fascia lata (AFL) group (3.0 ± 0.7 mm), while the FS with preserved fascia lata (PFL) group had the lowest mean postoperative MRD1 (2.2 ± 1.0 mm). The PFL group had significantly less lagophthalmos (0.6 ± 1.0 mm) than the AFL (1.9 ± 1.4 mm) and maximal levator resection (1.9 ± 1.7 mm) groups. In the MLR group, there was no significant difference in postoperative surgical measurements between the LF 0-2 mm group and LF 2.5-4 mm group in terms of exposure keratopathy, degree of lagophthalmos and MRD1. CONCLUSION: MLR is an effective alternative to FS in congenital ptosis patients with poor levator function, with the risk of postoperative lagophthalmos related to postoperative MRD1 rather than preoperative LF. SN - 1476-5454 UR - https://www.unboundmedicine.com/medline/citation/32651544/Lagophthalmos_after_congenital_ptosis_surgery:_comparison_between_maximal_levator_resection_and_frontalis_sling_operation L2 - http://dx.doi.org/10.1038/s41433-020-1081-z DB - PRIME DP - Unbound Medicine ER -
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