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Correction of severe blepharoptosis

W Deenstra1, P Melis, M Kon

  • 1Department of Plastic and Reconstructive Surgery, University Hospital of Utrecht, The Netherlands.

Annals of Plastic Surgery
|April 1, 1996
PubMed
Summary
This summary is machine-generated.

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Frontalis suspension using autogenous fascia is effective for severe blepharoptosis (levator function < 5 mm), yielding satisfactory results and good symmetry, especially in bilateral cases. This surgical technique offers a high success rate with minimal complications.

Area of Science:

  • Ophthalmology
  • Surgical Techniques
  • Reconstructive Surgery

Background:

  • Severe blepharoptosis, defined as levator function less than 5 mm, often shows insufficient results with standard levator resection.
  • Frontalis suspension using autogenous fascia is a preferred alternative for correcting severe blepharoptosis.

Purpose of the Study:

  • To analyze the outcomes of frontalis suspension with autogenous fascia for severe blepharoptosis.
  • To evaluate eyelid fissure width, symmetry, and patient satisfaction post-surgery.
  • To compare results between unilateral and bilateral blepharoptosis correction.

Main Methods:

  • Analysis of 81 patients undergoing frontalis suspension with fascia lata strips (Crawford technique).
  • Detailed description of the surgical technique.

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  • Assessment of postoperative vertical lid fissure, symmetry, and complications.

    • Main Results:

    • Satisfactory to excellent overall results with an average vertical lid fissure of 9 mm.
    • Better symmetry achieved in bilateral blepharoptosis correction (76% with <0.5 mm asymmetry) compared to unilateral (35%).
    • Symmetry is challenging in unilateral cases with a non-ptotic eye fissure ≥ 10 mm, suggesting bilateral correction.

    Conclusions:

    • Frontalis suspension with autogenous fascia is a successful and safe method for severe blepharoptosis.
    • Bilateral correction generally yields superior symmetry outcomes.
    • Optimal surgical timing for congenital cases is around 4-5 years old to better tolerate lagophthalmos and ensure adequate fascia availability.