Blepharoptosis repaired by frontalis-orbicularis oculi flap: a new technique

The treatment of blepharoptosis depends on the degree of ptosis and the function of the levator muscle. In cases of severe blepharoptosis, however, the levator muscle is essentially nonfunctional, thus frontal sling procedure, a static correction method, is usually performed. Recently the orbicularis oculi flap has become popular but lagopthalmos is still a bothersome problem. A new technique has been introduced in order to reduce the lagopthalmos.

Our technique is modified from a technique using double breast frontalis-orbicularis oculi muscle flap. The technique enhances mobility and amount of the pretarsal orbicularis oculi muscle and is devoid of vertical cutting of the flap and orbital septum involvement.

The technique was performed in 8 patients (12 lids) between 2007 and 2008. All patients were congenital and had severe ptosis. All of them were able to close their eyelids completely by 2 weeks. There was no complication in the series.

This novel technique yields an excellent result in cases of severe blepharoptosis. The technique is superior to the technique using frontalis muscle flap because there is only one incision, no forehead depression and no neurovascular injury. In addition, this technique also reduced period of lagopthalmos compared with the original technique.