A new non-incisional correction method for blepharoptosis

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Summary

Purpose

The present report introduces our correction method for blepharoptosis, in which major incisions are made on neither the skin nor the conjunctiva of the upper eyelid, and no dissection of the eyelid tissues is required.

Methods

After turning the upper eyelid inside out, threads are introduced into it through the conjunctiva close to the superior fornix. Then the superior palpebral levator muscle and the tarsus are connected using threads. This thread application is performed at two-to-four locations of the upper eyelid. By tightening the threads, the tarsus is elevated and the ptotic eyelid is corrected. A total of 624 eyelids in 390 patients with mild or moderate ptosis were operated on with this surgical method. Effectiveness of the treatment was evaluated referring to the degree of improvement. Furthermore, frequencies of complications were evaluated.

Results

Among 416 eyelids with mild ptosis, complete correction of ptosis was achieved with 406 eyelids (97.5%). Among 208 eyelids with moderate ptosis, improvement was achieved with 185 eyelids (88.9%), with complete correction for 156 eyelids (75%).

Conclusion

Since the present method enables effective correction of the blepharoptosis with a simple technique, minimised recovery time and no scarring, it provides a useful surgical option for the treatment of mild and moderate blepharoptosis.

Section snippets

Step 1

The locations at which suspension sutures are applied are marked on the upper eyelid (Figure 1). Since the positioning of the suspension suture affects the width and the curvature of the double fold, it is arranged according to the double-fold shape requested by patients. Two to four suspension sutures are usually applied per eyelid. Marks are made at the points (red in Figure 1) where the sutures intersect with the line on which the double fold is expected to be placed postoperatively (dotted

Effect for mild ptosis

In the postoperative evaluation of the 416 eyelids that had ‘mild’ ptosis preoperatively, 406 eyelids (97.5%) improved to ‘normal’; 10 eyelids (2.5%) remained mildly ptotic.

Effect for moderate ptosis

In the postoperative evaluation of the 208 eyelids that had ‘moderate’ ptosis preoperatively, 185 eyelids (75%) and 29 eyelids (13.9%) improved to ‘normal’ and ‘mild’, respectively. No improvement was found with 23 eyelids (11.1%) still presenting ‘moderate’ ptosis (Table 1).

Complications

Corneal itching and haematoma were present with 11

Discussion

Since blepharoptosis is one of the most frequently reported diseases in the field of plastic surgery, its treatment warrants great attention. Hence, numerous operative methods have been reported for its treatment. The optimal operation method is selected for each case, taking specific requirements of the case into consideration and referring to the degree of the ptosis and residual functionality of suspension muscles.

With mild or moderate blepharoptosis, the functioning of the superior levator

Conflict of interest

None.

Funding

None.

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Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.