Correction of congenital ptosis in patients with Blepharophimosis syndrome using combined levator and frontalis muscle advancement flaps: initial experience and clinical outcomes
Author: Ganna Lysenko
Base Hospital / Institution: Katharinenhospital, Klinikum Stuttgart, Department of Ophthalmology, Stuttgart, Germany
ePoster presentation
Abstract ID: 25-352
Purpose
Blepharophimosis syndrome (BPES) is one of the severe forms of congenital ptosis. BPES is characterized by blepharophimosis, ptosis, epicanthus inversus, and telecanthus. Frontalis suspension is a common technique to correct ptosis in patients with BPES. Our study aims to evaluate the outcomes of combined levator resection and frontalis muscle advancement for the surgical management of severe congenital ptosis in patients with BPES.
Methods
Five patients with bilateral BPES (10 eyelids) underwent combined levator and frontalis muscle advancement flaps. The age ranged from 1 to 36 years, with a mean of 9.4±13,6years. Preoperatively and postoperatively, the height of the palpebral fissure, the upper eyelid margin reflex distance (MRD1), and the levator function (LF) were analyzed.
Results
The mean levator function (LF) was 1.6 ± 2.0 mm. The mean preoperative height of the palpebral fissure was 4,2 ± 1.2 mm, and the mean MRD1 was 0.05 ± 0.7 mm. Five bilateral procedures with simultaneous Y-V medial canthoplasty for epicanthus correction were performed. Postoperatively, the height of the palpebral fissure was improved to 8 ± 0.9 mm, and the MRD1 increased to 3.9 ± 0.6 mm. All patients had natural eyelid contour, crease, and eyelash angle. No upper eyelid entropion or eyelid popping was observed.
Conclusion
Combined levator and frontalis muscle advancement flaps is an effective method to correct the severe congenital ptosis in patients with BPES, resulting in cosmetically pleasing outcomes. Advantages of this procedure include avoiding a brow suspension procedure with a foreign material and the absence of forehead scars.
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