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Kim, Choi, and Kim: Effect of the Simultaneous Operation of Levator Resection and Frontalis Suspension for Congenital Ptosis
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(12): 1737-1741.

Published online: 17 December 2012

DOI: https://doi.org/10.3341/jkos.2012.53.12.1737

Effect of the Simultaneous Operation of Levator Resection and Frontalis Suspension for Congenital Ptosis

Ah Ron Kim, MD, Chang Wook Choi, MD, Sang Duck Kim, MD, PhD

Department of Ophthalmology, Wonkwang University School of Medicine, Institute of Wonkwang Medical Science, Iksan, Korea.

Address reprint requests to Sang Duck Kim, MD, PhD. Department of Ophthalmology, Wonkwang University School of Medicine & Hospital, #895 Muwang-ro, Iksan 570-711, Korea. Tel: 82-63-859-1370, Fax: 82-63-855-1801, sangduck@wonkwang.ac.kr

Received 30 June 2012       Accepted 29 October 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To determine retrospectively if a simultaneous frontalis suspension could change the result of undercorrection observed during levator resection in congenital ptosis patients with poor levator functions.

Methods

Eight eyes in the present study were from 5 infants, 4 infants had congenital ptosis and 1 infant had blepharophimosis. The average age was 3.3 years (range: 1.5 to 6.9 years). If the upper lid margin was not positioned on the superior limbus after performing levator resection under general anesthesia, the height of the upper lid margin was controlled by simultaneous frontalis suspension.

Results

The average follow-up period was 29.8 months. After surgery on both eyes, all 8 cases showed good results and sudden relapse did not occur. Exposed corneal erosion was observed in 6 eyes, but with artificial tears, eye drops, and ointment there were significant improvements within 1 month in all cases. At final examinations, 6 out of 8 eyes showed excellent or good results; undercorrection in 2 eyes was observed and the lateral portion of ptosis in 1 eye was observed as an eye complication.

Conclusions

If undercorrection caused by levator resection occurs in patients with congenital ptosis, the combination of frontalis suspension surgery may reduce undercorrection and any recurrence that might appear after surgery.

Keywords: Congenital ptosis, Frontalis suspension, Levator resection

Figures and Tables

Figure 1
The procedure of the simultaneous levator resection and frontalis suspension for congenital ptosis. The procedure was performed from A to H. The upper lid margin was positioned to superior limbus level.
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Figure 2
Photograph show excellent results in both eyes after performing our procedure for congenital ptosis. (A) Preoperative photograph. (B) Intraoperative photograph after the last procedure. (C) Postoperative photograph after 13 months.
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Figure 3
Blepharophimosis infant shows undercorrection after 15 months follow-up. (A) Preoperative photograph. (B) Intraoperative photograph after the last procedure. (C) Postoperative the last follow-up photograph.
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Table 1
Characteristics and data of patients
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O.D = right eye; O.S = left eye; O.U = both eye.

References

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