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Area of Science:

  • Ophthalmology
  • Surgical Techniques
  • Eyelid Reconstructive Surgery

Background:

  • Blepharoptosis correction aims to restore eyelid function and aesthetics.
  • Frontalis muscle flap advancement and frontalis sling with autogenous fascia are common surgical approaches.
  • Assessing functional outcomes like spontaneous blinking is crucial for evaluating surgical success.

Purpose of the Study:

  • To quantitatively measure spontaneous blinking metrics (amplitude and velocity) after blepharoptosis correction using frontalis muscle flap advancement.
  • To compare these metrics with those obtained from frontalis sling surgery and a control group.
  • To evaluate the incidence of lagophthalmos and keratitis post-surgery.

Main Methods:

  • A video system was used to record and analyze spontaneous blinking in 24 eyelids post-frontalis flap surgery.
  • Comparison data from 13 eyelids previously operated with frontalis slings were utilized.
  • A control group without eyelid disorders was included. Superior margin reflex distance, lagophthalmos, and keratitis were also assessed.

Main Results:

  • Spontaneous blink amplitude was significantly reduced in both surgical groups (frontalis flap: 2.6 mm, fascia sling: 2.1 mm) compared to controls (6.3 mm).
  • Blink velocity was also significantly lower in the frontalis flap (39.0 mm/s) and fascia sling (36.3 mm/s) groups versus controls (133.8 mm/s).
  • No statistical difference in blinking metrics was observed between the frontalis flap and fascia sling groups. Lagophthalmos and keratitis showed no significant association with either surgical procedure.

Conclusions:

  • Frontalis muscle flap advancement and frontalis sling with autogenous fascia yield comparable spontaneous blinking metrics.
  • Neither surgical technique demonstrated a significant difference in the occurrence of lagophthalmos or keratitis.
  • Both surgical methods result in altered, but similar, functional blinking characteristics compared to normal controls.