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Surgical treatment of unilateral severe simple congenital ptosis
Unilateral congenital ptosis with poor levator function of ≤4 mm continues to be a difficult challenge for the oculoplastic surgeon. Surgical correction can be accomplished with unilateral frontalis suspension, maximal levator resection, or bilateral frontalis suspension with or without levator musc...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2018
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5890581/ https://www.ncbi.nlm.nih.gov/pubmed/29675342 http://dx.doi.org/10.4103/tjo.tjo_70_17 |
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author | Lee, Ju-Hyang Kim, Yoon-Duck |
author_facet | Lee, Ju-Hyang Kim, Yoon-Duck |
author_sort | Lee, Ju-Hyang |
collection | PubMed |
description | Unilateral congenital ptosis with poor levator function of ≤4 mm continues to be a difficult challenge for the oculoplastic surgeon. Surgical correction can be accomplished with unilateral frontalis suspension, maximal levator resection, or bilateral frontalis suspension with or without levator muscle excision of the normal eyelid. Bilateral frontalis suspension was proposed by Beard and Callahan to overcome the challenge of postoperative asymmetry, allowing symmetrical lagophthalmos on downgaze, postoperatively. However, most surgeons and patients prefer unilateral correction on the abnormal eyelid either with a frontalis suspension or maximal levator resection. Frontalis suspension may be performed through the various surgical techniques using different autogenous or exogenous materials. Autogenous fascia lata is considered the material of choice with low recurrence rates but carries the drawbacks of the difficulty of harvesting and postoperative morbidity from the second surgical site. Recent reports have suggested that maximal levator resection provides improved cosmesis, a more natural contour, and avoids brow scars. Although both treatments have shown to have similar success rates, there is much debate about what the most favorable method for treating severe unilateral ptosis. We review the literature on the various surgical treatments for unilateral severe congenital ptosis, including the rationale, advantages and disadvantages of each technique. |
format | Online Article Text |
id | pubmed-5890581 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-58905812018-04-19 Surgical treatment of unilateral severe simple congenital ptosis Lee, Ju-Hyang Kim, Yoon-Duck Taiwan J Ophthalmol Review Article Unilateral congenital ptosis with poor levator function of ≤4 mm continues to be a difficult challenge for the oculoplastic surgeon. Surgical correction can be accomplished with unilateral frontalis suspension, maximal levator resection, or bilateral frontalis suspension with or without levator muscle excision of the normal eyelid. Bilateral frontalis suspension was proposed by Beard and Callahan to overcome the challenge of postoperative asymmetry, allowing symmetrical lagophthalmos on downgaze, postoperatively. However, most surgeons and patients prefer unilateral correction on the abnormal eyelid either with a frontalis suspension or maximal levator resection. Frontalis suspension may be performed through the various surgical techniques using different autogenous or exogenous materials. Autogenous fascia lata is considered the material of choice with low recurrence rates but carries the drawbacks of the difficulty of harvesting and postoperative morbidity from the second surgical site. Recent reports have suggested that maximal levator resection provides improved cosmesis, a more natural contour, and avoids brow scars. Although both treatments have shown to have similar success rates, there is much debate about what the most favorable method for treating severe unilateral ptosis. We review the literature on the various surgical treatments for unilateral severe congenital ptosis, including the rationale, advantages and disadvantages of each technique. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC5890581/ /pubmed/29675342 http://dx.doi.org/10.4103/tjo.tjo_70_17 Text en Copyright: © 2018 Taiwan J Ophthalmol http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Review Article Lee, Ju-Hyang Kim, Yoon-Duck Surgical treatment of unilateral severe simple congenital ptosis |
title | Surgical treatment of unilateral severe simple congenital ptosis |
title_full | Surgical treatment of unilateral severe simple congenital ptosis |
title_fullStr | Surgical treatment of unilateral severe simple congenital ptosis |
title_full_unstemmed | Surgical treatment of unilateral severe simple congenital ptosis |
title_short | Surgical treatment of unilateral severe simple congenital ptosis |
title_sort | surgical treatment of unilateral severe simple congenital ptosis |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5890581/ https://www.ncbi.nlm.nih.gov/pubmed/29675342 http://dx.doi.org/10.4103/tjo.tjo_70_17 |
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