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Abstract
Purpose:
To present a simple method of acquired ptosis correction by small-incision minimal dissection technique and assess the results of the operation.
Methods:
The charts of 23 patients (29 eyes) with acquired ptosis who underwent ptosis correction by small-incision minimal dissection technique were reviewed. Pre and postoperative MRD1, success rate, complications and reoperation rates were investigated.
Results:
The average of pre− and postoperative MRD1 were 0.9±0.9 mm and 2.7±0.8 mm respectively. Of the 17 patients who underwent unilateral surgery, 15 eyes (88.2%) showed successful outcomes, and of the 12 eyes who underwent bilateral surgery, 8 eyes (66.6%), 2 eyes (16.7%), and 2 eyes (16.7%) showed excellent, good, and poor outcomes, respectively. Out of 29 eyes, 25 eyes (86.2%) showed satisfactory results. Two eyelids of unsatisfactory contour were corrected by reoperation.
Conclusions:
Although the small-incision minimal dissection technique for ptosis correction is applicable to a restricted group of patients compared to the conventional method, this technique is very useful and efficient, and has many advantages including less tissue damage, bleeding, edema, a short operation time and rapid recovery.
References
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Figure 1.
Procedures of small cutaneous incision and minimal dissection technique for ptosis correction. (A) A length of 8 to 10-mm skin marking was drawn along the lid crease above the center of the pupil. (B) Tarsal plate was exposed after dissecting the pretarsal orbicularis. (C) Preaponeurotic fat pad was identified after incising the orbital septum over the tarsal plate. (D) Dissection of levator aponeurosis was carried out to a point at the level of musculo-aponeurotic junction. (E) A partial thickness suture of tarsal plate was placed in a horizontal fashion with more than 5-mm width. (F) The double armed, non absorbable suture was passed through the levator aponeurosis in the appropriate position. (G) The fixation suture was tied after inspecting the eyelid position and contour. (H) Finally, the skin was closed.
Table 1.
Characteristics of patients
Table 2.
Distribution and differences of preoperative and postoperative MRD1
| Range (mm) | No. of eyes | |
|---|---|---|
| Preop. MRD1 | Postop. MRD1 | |
| < 0 | 5 | 0 |
| 0-0.9 | 12 | 2 |
| 1-1.9 | 9 | 2 |
| 2-2.9 | 3 | 14 |
| 3-3.9 | 0 | 11 |
| Average (mm) | 0.9±0.9 mm | 2.7±0.8 mm |
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