Objective: To evaluate the effectiveness of an arc-shaped frontalis aponeurosis flap for the treatment of moderate to severe blepharoptosis.
Methods: Between January 2011 and December 2014, 80 cases (140 eyes) of moderate to severe blepharoptosis were treated, including 31 males and 49 females with a median age of 16 years (range, 6-45 years). One eye was involved in 20 cases and both eyes in 60 cases. Upper eyelid ptosis degree ranged from 3 to 6 mm (average, 5 mm) when looking at the front horizontally. Fifty-one patients had underwent plastic surgery, and the first operation was performed in others. The arc-shaped frontalis aponeurosis flap was created by incision of upper and middle edge of the eyebrow, then it was retracted to the upper eyelid aponeurosis and was fixed in a slight over-correction position.
Results: The operation was completed smoothly. The intraoperative blood loss was 5-10 mL (mean, 7 mL). Mild swelling of incision was observed after operation, and disappeared at 3-5 days after operation. Primary healing of incision was obtained, with no complications of infection and flap necrosis. The follow-up duration was 1-3 years (mean, 1.5 years). Seventy-nine cases could close upper eyelid completely and the function of upper eyelid was satisfactory within 3 months. One patient could not close upper eyelid completely after 6 months, and mild keratitis occurred, which was cured by anchyloblepharon.
Conclusion: The arc-shaped frontalis aponeurosis flap can be regarded as a minimally invasive procedure for the treatment of cogenital moderate to severe blepharoptosis, it was safe, reliable, and easy-to-grasp.