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Analysis of Levator Function and Ptosis Severity in Involutional Blepharoptosis.
Hsin-Ti Lai1, Shih-Feng Weng, Chih-Hau Chang
1From the *Plastic Surgery Department, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; and †Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.
Annals of Plastic Surgery
|February 15, 2017
Summary
In involutional blepharoptosis, levator function (LF) is often normal, but abnormal LF occurs in 23% of cases. Levator function and eyelid ptosis severity showed a positive correlation in Taiwanese patients.
Area of Science:
- Ophthalmology
- Oculoplastics
- Anatomy and Physiology
Background:
- Involutional blepharoptosis, the most common acquired ptosis, is typically linked to levator aponeurosis degeneration.
- Previous research suggested normal levator muscle function in this condition, but limited studies exist.
- This study investigates levator function abnormalities and their correlation with ptosis severity in Taiwanese patients.
Purpose of the Study:
- To assess levator function (LF) abnormalities in involutional blepharoptosis.
- To analyze the correlation between LF and the severity of ptosis.
- To examine the prevalence of fat infiltration in the levator muscle.
Main Methods:
- Retrospective review of 231 eyelids from 126 patients diagnosed with involutional blepharoptosis.
- Analysis of patient demographics, preoperative levator function (LF), and margin reflex distance of the upper eyelid (MRD1).
- Statistical analysis using linear regression and pathological examination of levator muscle specimens.
Main Results:
- Average LF was 14.30 ± 2.51 mm, with 77.1% of eyelids exhibiting normal LF (>12 mm).
- Abnormal LF was observed in 23.0% of eyelids (good: 18.6%, fair: 4.3%).
- A positive correlation was found between LF and MRD1 (0.6 mm reduction in LF per 1.0 mm decrease in MRD1); fat infiltration was common in levator muscles.
Conclusions:
- Levator function and MRD1 are positively correlated in involutional blepharoptosis.
- A significant percentage (23.0%) of eyelids demonstrated abnormal levator function, contrary to prior assumptions.
- Fat infiltration of the levator muscle is a frequent finding in Asian involutional blepharoptosis, impacting levator function and ptosis severity.
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