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Updated: Mar 3, 2026

Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Evaluation of the complex treatment for congenital blepharoptosis
Aleksandra Iljin1, Tomasz Zieliński1, Anna Broniarczyk-Loba2
1Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Łódź, Institute of Surgery.
Insights
Surgical correction of congenital blepharoptosis (CBP) using Mustarde or modified Mustarde methods yielded very good results in children. However, visual system disorders like amblyopia were common post-surgery.
Area of Science:
- Ophthalmology
- Plastic Surgery
- Pediatric Surgery
Background:
- Congenital blepharoptosis (CBP) affects eyelid function and visual development in children.
- Surgical intervention is necessary to correct CBP and prevent visual impairment.
Purpose of the Study:
- To assess the outcomes of surgical treatments for congenital blepharoptosis (CBP).
- To evaluate co-occurring visual system disorders in pediatric patients with CBP.
Main Methods:
- Retrospective analysis of 52 children with CBP undergoing surgical correction between 2001 and 2010.
- Surgical techniques included modified Mustarde, original Mustarde, or frontal suspension.
- Ophthalmic and orthoptic examinations, along with standard measurements, were used to analyze outcomes.
Main Results:
- Excellent results were achieved in mild unilateral CBP cases.
- Very good outcomes were observed in moderate/severe unilateral and bilateral CBP after Mustarde or modified Mustarde procedures.
- Complications included lagophthalmos (15.4%) and undercorrection (3.8%).
- Significant visual system disorders, primarily amblyopia, were present in 88.5% of patients.
Conclusions:
- Comprehensive ophthalmic evaluations are crucial for accurate diagnosis and timely surgical intervention in CBP.
- Surgical methods that shorten the levator palpebrae superioris are effective for CBP correction.
- The modified Mustarde method enhances favorable postoperative results in CBP treatment.
Objective:
To evaluate the results of treatment of congenital blepharoptosis (CBP) using selected surgical methods; and to evaluate concomitant visual system disorders.
Methods:
Between 2001 and 2010, 52 children with CBP underwent surgical correction of CBP using the modified method of Mustarde, the original Mustarde method or frontal suspension at the Department of Plastic Surgery, Medical University of Lodz (Poland). Based on the results of ophthalmic and orthoptic examination, and standard measurements, postoperative differences in the position and symmetry of the upper eyelids, complications, and visual system abnormalities were analyzed.
Results:
Very good results were obtained in all patients with mild unilateral CBP. The results in patients with moderate and severe unilateral CBP, and in bilateral anomaly after correction using Mustarde's method or the modified Mustarde's method, were also very good. Complications included lagophthalmos (15.4%) and undercorrection (3.8%). Visual system disorders, mainly amblyopia, resulting from strabismus, astigmatism, anisometropia and CBP, were observed in 88.5% of patients.
Conclusions:
Complex ophthalmic examination and measurements in individuals with CBP enable correct diagnosis, selection of appropriate treatment method and timing of surgical intervention. Postoperative results in patients with CBP supported the efficacy of the methods that shortened the levator palpebrae superioris. Supplementing with Mustarde's modified method contributed to an increase in the number of favourable postoperative results.
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