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Frontalis Muscle Flap Repair for Conjunctival Prolapse With Tarsal Plate Eversion After Severe Congenital Ptosis
Junxiu Liu1, Zhen Liu2, Lei Liu2,3
1Department of Ophthalmology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia Hui Autonomous Region.
Insights
Frontalis muscle flap surgery effectively repairs conjunctival prolapse with tarsal plate eversion after congenital ptosis correction. This method preserves eyelid structures and ensures satisfactory long-term cosmetic and functional outcomes.
Area of Science:
- Ophthalmology
- Plastic Surgery
- Pediatric Surgery
Background:
- Severe congenital ptosis can lead to complications after surgical correction.
- Conjunctival prolapse with tarsal plate eversion is a rare but significant postoperative complication.
Purpose of the Study:
- To evaluate the effectiveness of frontalis muscle flap surgery for correcting conjunctival prolapse with tarsal plate eversion.
- To assess the functional and cosmetic outcomes of this surgical technique.
Main Methods:
- Retrospective analysis of patients undergoing congenital ptosis repair from January 2014 to December 2023.
- Identification of patients who developed conjunctival prolapse with tarsal plate eversion post-surgery.
- Correction of the complication using frontalis muscle flap surgery.
Main Results:
- Six patients (3 boys, 3 girls) developed conjunctival prolapse with tarsal plate eversion after severe congenital ptosis repair.
- Frontalis muscle flap surgery successfully repositioned the prolapsed conjunctiva in all cases.
- Ideal upper eyelid height was maintained at a 3-year follow-up, with all patients reporting satisfaction.
Conclusions:
- Frontalis muscle flap surgery is an effective treatment for conjunctival prolapse with tarsal plate eversion following congenital ptosis repair.
- The technique preserves conjunctiva and tarsus, ensuring good eyelid height and aesthetic results.
- This approach offers favorable functional and cosmetic outcomes for patients.
Objective:
To evaluate the efficacy of frontalis muscle flap surgery in repairing conjunctival prolapse with tarsal plate eversion following severe congenital ptosis correction.
Methods:
A retrospective analysis was conducted of patients who underwent correction of congenital ptosis at our institution between January 2014 and December 2023. Patients meeting the inclusion criteria for conjunctival prolapse with tarsal plate eversion were reviewed, and frontalis muscle flap surgery was performed for correction.
Results:
Among 1472 patients with congenital ptosis, 740 had severe cases, and 6 developed postoperative conjunctival prolapse with tarsal plate eversion. Five cases were unilateral, and 1 was bilateral, involving 3 boys and 3 girls. All patients initially underwent levator advancement with tendon shortening, and conjunctival prolapse developed between postoperative days 2 and 7. Following correction using frontalis muscle flap surgery, the prolapsed conjunctiva was successfully repositioned, and ideal upper eyelid height was maintained at the 3-year follow-up. All patients were satisfied with the outcomes.
Conclusion:
Frontalis muscle flap surgery effectively corrects conjunctival prolapse with tarsal plate eversion after congenital ptosis repair. The technique avoids excision of the conjunctiva and tarsus, maintains eyelid height, and achieves good cosmetic and functional results.
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