Postoperative levator function change in patients with unilateral myogenic versus aponeurotic blepharoptosis

Mohsen Bahmani Kashkouli; Parya Abdolalizadeh; Anahita Amirsardari; Houri Esmaeilkhanian; Mahya Ghazizadeh; Farideh Moradpasandi

doi:10.1016/j.bjps.2019.06.005

Postoperative levator function change in patients with unilateral myogenic versus aponeurotic blepharoptosis

J Plast Reconstr Aesthet Surg. 2019 Oct;72(10):1675-1681. doi: 10.1016/j.bjps.2019.06.005. Epub 2019 Jun 27.

Authors

Mohsen Bahmani Kashkouli¹, Parya Abdolalizadeh², Anahita Amirsardari², Houri Esmaeilkhanian², Mahya Ghazizadeh², Farideh Moradpasandi²

Affiliations

¹ Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Sattarkhan Niayesh St., Tehran 1455364, Iran. Electronic address: info@eyeplasticsurgeries.com.
² Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Sattarkhan Niayesh St., Tehran 1455364, Iran.

PMID: 31272877
DOI: 10.1016/j.bjps.2019.06.005

Abstract

Purpose: To compare the change in levator function (LF) after levator resection in patients with unilateral myogenic (MP) and aponeurotic ptosis (AP).

Methods: In a prospective study, patients of >5 years old were included from June 2015 to April 2017. Other types of ptosis, associated strabismus and previous eyelid surgery were excluded. Eyelid examination and photography were performed before and at least 6 months after surgery. Success was defined as Margin reflex distance 1 (MRD1) of within 0.5 mm of the unoperated side. All procedures (levator resection) were performed by or under supervision of one surgeon.

Results: There were 58 patients in the MP (mean age: 19.2 years) and 20 in the AP (mean age: 49.5) group with median follow up of 10 months. LF was significantly improved from 5.8 to 7.3 mm in the MP and from 11.8 to 13.6 mm in the AP group. LF improvement was not observed in 17.2% of MP and 25% of AP group (P = 0.5). Mean preoperative LF was significantly (Odd ratio = 1.8) higher in patients with than without LF improvement in the MP group. It was significantly reverse in the AP group (Odd ratio = 0.38). A significantly positive (r = 0.30) and negative (r = -0.72) correlations were observed between preoperative LF and LF improvement in the MP and AP groups, respectively. Success was observed in 90% of AP and 84.5% of MP group. In order of frequency, undercorrection, overcorrection, and contour abnormality were the reasons for failure. No variable significantly affected the success rate in either group.

Conclusion: Majority of MP and AP showed postoperative LF improvement. While higher preoperative LF was significantly correlated with LF improvement in the MP, it was reverse in the AP group. Success rate was not significantly different between the groups and no factor significantly affected the success in either group.

Keywords: Aponeurotic ptosis; Blepharoptosis; Levator function; Levator resection; Myogenic ptosis.

Publication types

Comparative Study

MeSH terms

Adult
Analysis of Variance
Blepharoplasty / methods*
Blepharoptosis / diagnosis*
Blepharoptosis / surgery*
Cohort Studies
Female
Follow-Up Studies
Hospitals, University
Humans
Iran
Male
Middle Aged
Oculomotor Muscles / physiopathology*
Oculomotor Muscles / surgery*
Patient Satisfaction / statistics & numerical data
Retrospective Studies
Risk Assessment
Severity of Illness Index
Treatment Outcome
Young Adult