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Maximal levator resection versus Gore-Tex(®) sling for congenital blepharoptosis with poor levator function

BACKGROUND: Treating congenital blepharoptosis is often mandatory to clear the visual access and avoid amblyopia; however, when the levator function is poor, achieving a satisfactory long-term outcome is challenging. This study aimed to compare the outcomes of maximal levator resection (MLR) with th...

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Autores principales: Dawood, Ahmed Said, Hassan, Omar Abdelghany, El Sayed, Mohamed Othman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8597826/
https://www.ncbi.nlm.nih.gov/pubmed/34880579
http://dx.doi.org/10.4103/ojo.ojo_127_21
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author Dawood, Ahmed Said
Hassan, Omar Abdelghany
El Sayed, Mohamed Othman
author_facet Dawood, Ahmed Said
Hassan, Omar Abdelghany
El Sayed, Mohamed Othman
author_sort Dawood, Ahmed Said
collection PubMed
description BACKGROUND: Treating congenital blepharoptosis is often mandatory to clear the visual access and avoid amblyopia; however, when the levator function is poor, achieving a satisfactory long-term outcome is challenging. This study aimed to compare the outcomes of maximal levator resection (MLR) with those of frontalis suspension (FS) using Gore-Tex (®), in the treatment of congenital blepharoptosis with poor levator function. PATIENTS AND METHODS: The study included 102 eyelids of 66 patients of mean age 4.3 ± 1.6 standard deviation (SD) years, randomly divided into two groups (51 eyes each). Group A: FS using Gore-Tex (®), Group B: MLR. Postoperative outcomes were evaluated at 1, 6 and 12 months. Patients' ophthalmic examination including margin-reflex distance (MRD1) before and after surgery and postoperative complications were recorded. RESULTS: At the end of the follow-up, the mean MRD1 increased from 0.3 ± 0.7 SD mm in Group A, 0.4 ± 0.8 SD mm in Group B preoperatively, to 2.7 ± 0.5 SD mm and 2.9 ± 0.7 SD mm, respectively (P < 0.001 in both groups). Results of Group B were significantly higher than Group A (P = 0.047). Success was achieved in 77 eyelids (75.4%), distributed as follows: 36 eyelids (70.6%) in Group A, and 41 eyelids (80.1%) in Group B. The total recurrence rate was 6.9% (seven eyes), while other complications were recorded in 23 eyes (22.5%). CONCLUSION: MLR, compared to FS with Gore-Tex(®) sling, can be a more efficient surgical option to correct congenital blepharoptosis with poor levator excursion. Prominent postoperative lagophthalmos warrants close ocular surface observation in early follow-up weeks.
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spelling pubmed-85978262021-12-07 Maximal levator resection versus Gore-Tex(®) sling for congenital blepharoptosis with poor levator function Dawood, Ahmed Said Hassan, Omar Abdelghany El Sayed, Mohamed Othman Oman J Ophthalmol Original Article BACKGROUND: Treating congenital blepharoptosis is often mandatory to clear the visual access and avoid amblyopia; however, when the levator function is poor, achieving a satisfactory long-term outcome is challenging. This study aimed to compare the outcomes of maximal levator resection (MLR) with those of frontalis suspension (FS) using Gore-Tex (®), in the treatment of congenital blepharoptosis with poor levator function. PATIENTS AND METHODS: The study included 102 eyelids of 66 patients of mean age 4.3 ± 1.6 standard deviation (SD) years, randomly divided into two groups (51 eyes each). Group A: FS using Gore-Tex (®), Group B: MLR. Postoperative outcomes were evaluated at 1, 6 and 12 months. Patients' ophthalmic examination including margin-reflex distance (MRD1) before and after surgery and postoperative complications were recorded. RESULTS: At the end of the follow-up, the mean MRD1 increased from 0.3 ± 0.7 SD mm in Group A, 0.4 ± 0.8 SD mm in Group B preoperatively, to 2.7 ± 0.5 SD mm and 2.9 ± 0.7 SD mm, respectively (P < 0.001 in both groups). Results of Group B were significantly higher than Group A (P = 0.047). Success was achieved in 77 eyelids (75.4%), distributed as follows: 36 eyelids (70.6%) in Group A, and 41 eyelids (80.1%) in Group B. The total recurrence rate was 6.9% (seven eyes), while other complications were recorded in 23 eyes (22.5%). CONCLUSION: MLR, compared to FS with Gore-Tex(®) sling, can be a more efficient surgical option to correct congenital blepharoptosis with poor levator excursion. Prominent postoperative lagophthalmos warrants close ocular surface observation in early follow-up weeks. Wolters Kluwer - Medknow 2021-10-20 /pmc/articles/PMC8597826/ /pubmed/34880579 http://dx.doi.org/10.4103/ojo.ojo_127_21 Text en Copyright: © 2021 Oman Ophthalmic Society https://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 Original Article
Dawood, Ahmed Said
Hassan, Omar Abdelghany
El Sayed, Mohamed Othman
Maximal levator resection versus Gore-Tex(®) sling for congenital blepharoptosis with poor levator function
title Maximal levator resection versus Gore-Tex(®) sling for congenital blepharoptosis with poor levator function
title_full Maximal levator resection versus Gore-Tex(®) sling for congenital blepharoptosis with poor levator function
title_fullStr Maximal levator resection versus Gore-Tex(®) sling for congenital blepharoptosis with poor levator function
title_full_unstemmed Maximal levator resection versus Gore-Tex(®) sling for congenital blepharoptosis with poor levator function
title_short Maximal levator resection versus Gore-Tex(®) sling for congenital blepharoptosis with poor levator function
title_sort maximal levator resection versus gore-tex(®) sling for congenital blepharoptosis with poor levator function
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8597826/
https://www.ncbi.nlm.nih.gov/pubmed/34880579
http://dx.doi.org/10.4103/ojo.ojo_127_21
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