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[Treatment of ptosis in children and adults]
Insights
This study reviews 54 ptosis surgeries in 46 patients, detailing surgical techniques like Fasanella-Servat resection and frontotarsal suspension for congenital and acquired eyelid ptosis.
Area of Science:
- Ophthalmology
- Surgical Techniques
- Eyelid Anatomy
Context:
- Pathological ptosis, or drooping eyelid, presents at birth (congenital) or develops later in life (acquired).
- Congenital ptosis includes syndromes like blepharophimosis and Marcus-Gunn syndrome.
- Acquired ptosis has diverse causes, including mechanical, myogenic, neurogenic, and aponeurotic factors.
Purpose:
- To analyze surgical outcomes for various types of pathological eyelid ptosis.
- To present surgical interventions performed over three years at a specific ophthalmological clinic.
- To detail the application of different surgical methods based on ptosis etiology.
Summary:
- The study involved 46 patients (ages 3-70) undergoing 54 ptosis operations.
- Procedures included Fasanella-Servat tarsal plate resection (29 eyes), levator aponeurosis repair (4 eyes), and frontotarsal suspension using allogeneic fascia (21 eyes).
- The authors describe the preparation of freeze-dried allogeneic fascia for surgical use.
Impact:
- Provides insights into the efficacy of different surgical approaches for ptosis correction.
- Highlights the use of allogeneic fascia in frontotarsal suspension for paretic ptosis.
- Contributes to the understanding of surgical management for a range of eyelid ptosis conditions.
Abstract:
Pathological ptosis of the eyelids can be manifest already at birth but may develop also in advanced age. In children the congenital form predominates with or without affection of the elevators of the eyes (Congenital fibrous syndrome or Misdirection syndrome). A special form is blepharophimosis, juvenile blepharochalasis and Marcus-Gunn's syndrome. In adult age the etiology of acquired ptosis of the upper eyelid is more varied. There are mechanical causes incl. dermatochalasis or it develops on a myogenic and neurogenic background or as the aponeurotic form. The group comprises 46 patients 3-70 years old where in the course of the last three years at the Ophthalmological Clinic of the Faculty Hospital Prague Vinohrady a total of 54 operations of ptoses were made. Resection of the tarsal plate according to Fasanella-Servat was used in 29 instances. In four eyes a plastic operation of the aponeurosis of the levator was performed. Frontotarsal suspension in the authors modification of Fox method using deep freeze-dried allogenei fasciae was used in the paretic form of ptosis in 21 eyes. The authors give also an account of the technological preparation of a fascial graft kept at a temperature of -80 degrees C.