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Involutional ptosis: recognition and management.

P A Martin, P A Rogers

    Australian and New Zealand Journal of Ophthalmology
    |May 1, 1985
    PubMed
    Summary
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    Involutional ptosis, often linked to aponeurotic defects, can be effectively treated surgically. This study highlights successful surgical outcomes for ptosis patients, recommending specific anesthetic and surgical techniques for optimal results.

    Area of Science:

    • Ophthalmology
    • Surgical Science

    Background:

    • Involutional ptosis is characterized by varying degrees of eyelid drooping.
    • Key clinical signs include good levator muscle function, a high upper eyelid fold, and increased lid movement during downgaze.
    • Increased upper eyelid translucency may also be present.

    Purpose of the Study:

    • To investigate the prevalence and characteristics of aponeurotic defects in adult ptosis cases.
    • To evaluate the efficacy of phenylephrine testing in diagnosing ptosis.
    • To recommend optimal surgical and anesthetic strategies for involutional ptosis.

    Main Methods:

    • A retrospective review of adult ptosis cases treated at Sydney Eye Hospital over three years.
    • Identification of cases with aponeurotic defects, including dehiscence or disinsertion.

    Related Experiment Videos

  • Assessment of the utility of the 10% phenylephrine test.

    • Main Results:

    • Twenty cases of adult ptosis with aponeurotic defects were identified.
    • Ninety percent of these cases exhibited a positive response to the 10% phenylephrine test.
    • The study identified specific surgical recommendations for managing involutional ptosis.

    Conclusions:

    • Aponeurotic defects are a significant factor in involutional ptosis.
    • The phenylephrine test is a valuable diagnostic tool for ptosis.
    • Surgery under local anesthesia without adrenaline, with 1-2 mm overcorrection, is recommended for optimal outcomes in involutional ptosis repair.