ePoster listing and sessions

Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London

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Surgical correction of blepharophimosis, ptosis and epicanthus inversus syndrome (BPES)

Author: Ana Fakin
ePoster Number: 241


To review surgical management of Slovenian patients with BPES.


Retrospective study included 16 BPES patients (9 male) from 11 families; who underwent surgical eyelid correction at the Oculoplastic department of Eye Hospital, University Medical Centre Ljubljana in the period from 1981-2021.


All patients underwent medial canthoplasty, with either Y-V plasty (N=15) or double Z plasty (N=1) and 56 % (9/16) also lateral cantholysis. Ptosis correction was performed in 88 % (14/16) of patients, in 12/14 bilaterally. Frotalis sling was used as the primary approach in 36 % (5/14) of cases, performed at the median age of 1 year (range, 1-4 years). These patients were at risk for amblyopia and had no or minimal levator function. Either silicone, Mersilene or Gore-Tex material was used to form the sling. One patient needed revision of the sling and one patient had an additional levator resection at the age of 18 years, when the levator function reached 4 mm. In 64 % (9/14) of patients, levator resection with sulcus formation was used as the primary approach, at the median age of 7 years (range, 3-45 years). These patients had normal visual development and levator function of at least 4 mm. A thick fibrous plate was often observed in the place of the levator muscle and excised during surgery. In four cases, additional levator resection was performed later-on, following the growth of the levator muscle; while in one case an additional frontalis sling was performed. In the end, all patients had a clear visual axis and a satisfactory aesthetic appearance.


Using an individual patient-tailored approach a good aesthetic and functional outcome was achieved in all patients. Along with lateral and/or medial canthoplasty, suspension surgery is indicated in the first years of life in patients with risk of amblyopia. In patients with normal visual development, however, surgery is best delayed to allow levator muscle growth. In these cases levator resection with the excision of fibrous tissue and sulcus formation is the procedure of choice, which results in the most natural look.

Additional Authors

First nameLast nameBase Hospital / Institution
AzraHercegEye Hospital, University Medical Centre Ljubljana, Slovenia
BrigitaDrnovšek OlupEye Hospital, University Medical Centre Ljubljana, Slovenia

Abstract ID: 21-136