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Levator Resection in the Management of Myopathic Ptosis

PURPOSE: To evaluate the results of levator resection in patients with myopathic ptosis. METHODS: The medical records of consecutive patients who underwent levator resection surgery performed for myopathic ptosis between October 2009 and March 2013 were reviewed. Indications for surgery were ptosis...

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Detalles Bibliográficos
Autores principales: Buttanri, Ibrahim Bulent, Serin, Didem
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Ophthalmological Society 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4239460/
https://www.ncbi.nlm.nih.gov/pubmed/25435744
http://dx.doi.org/10.3341/kjo.2014.28.6.431
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author Buttanri, Ibrahim Bulent
Serin, Didem
author_facet Buttanri, Ibrahim Bulent
Serin, Didem
author_sort Buttanri, Ibrahim Bulent
collection PubMed
description PURPOSE: To evaluate the results of levator resection in patients with myopathic ptosis. METHODS: The medical records of consecutive patients who underwent levator resection surgery performed for myopathic ptosis between October 2009 and March 2013 were reviewed. Indications for surgery were ptosis obscuring the visual axis and margin-reflex distance ≤2 mm. Surgical success was defined as clear pupillary axis when the patient voluntarily opened his eye and margin-reflex distance ≥3 mm. We analyzed the effect of levator function and Bell's phenomenon on the rates of success and corneal complication. RESULTS: This series included six male and six female patients. Levator function was between 4 and 12 mm. We performed bilateral levator resection surgery in all patients. The mean follow-up time was 14.8 months (range, 6 to 36 months). No patient was overcorrected. Adequate lid elevation was achieved after the operation in 20 eyes. Ptosis recurred in three out of 20 eyes after adequate lid elevation was achieved. Our overall success rate was 70.8%. In three eyes with poor Bell's phenomenon, corneal irritation and punctate epitheliopathy that required artificial eye drops and ointments developed in the early postoperative period, although symptoms resolved completely within 2 months of the resection surgery. No patients required levator recession or any other revision surgery for lagophthalmos or corneal exposure after levator resection. CONCLUSIONS: Levator resection seems to be a safe and effective procedure in myopathic patients with moderate or good Bell's phenomenon and levator function greater than 5 mm.
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spelling pubmed-42394602014-12-01 Levator Resection in the Management of Myopathic Ptosis Buttanri, Ibrahim Bulent Serin, Didem Korean J Ophthalmol Original Article PURPOSE: To evaluate the results of levator resection in patients with myopathic ptosis. METHODS: The medical records of consecutive patients who underwent levator resection surgery performed for myopathic ptosis between October 2009 and March 2013 were reviewed. Indications for surgery were ptosis obscuring the visual axis and margin-reflex distance ≤2 mm. Surgical success was defined as clear pupillary axis when the patient voluntarily opened his eye and margin-reflex distance ≥3 mm. We analyzed the effect of levator function and Bell's phenomenon on the rates of success and corneal complication. RESULTS: This series included six male and six female patients. Levator function was between 4 and 12 mm. We performed bilateral levator resection surgery in all patients. The mean follow-up time was 14.8 months (range, 6 to 36 months). No patient was overcorrected. Adequate lid elevation was achieved after the operation in 20 eyes. Ptosis recurred in three out of 20 eyes after adequate lid elevation was achieved. Our overall success rate was 70.8%. In three eyes with poor Bell's phenomenon, corneal irritation and punctate epitheliopathy that required artificial eye drops and ointments developed in the early postoperative period, although symptoms resolved completely within 2 months of the resection surgery. No patients required levator recession or any other revision surgery for lagophthalmos or corneal exposure after levator resection. CONCLUSIONS: Levator resection seems to be a safe and effective procedure in myopathic patients with moderate or good Bell's phenomenon and levator function greater than 5 mm. The Korean Ophthalmological Society 2014-12 2014-11-19 /pmc/articles/PMC4239460/ /pubmed/25435744 http://dx.doi.org/10.3341/kjo.2014.28.6.431 Text en © 2014 The Korean Ophthalmological Society http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Buttanri, Ibrahim Bulent
Serin, Didem
Levator Resection in the Management of Myopathic Ptosis
title Levator Resection in the Management of Myopathic Ptosis
title_full Levator Resection in the Management of Myopathic Ptosis
title_fullStr Levator Resection in the Management of Myopathic Ptosis
title_full_unstemmed Levator Resection in the Management of Myopathic Ptosis
title_short Levator Resection in the Management of Myopathic Ptosis
title_sort levator resection in the management of myopathic ptosis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4239460/
https://www.ncbi.nlm.nih.gov/pubmed/25435744
http://dx.doi.org/10.3341/kjo.2014.28.6.431
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