OBJECTIVE: To summarize the etiology mechanism and treatment of iatrogenic blepharoptosis after double eyelid surgery in Asia. METHODS: To extensively review the literature related to iatrogenic blepharoptosis after double eyelid surgery, and to summarize and analyze the related anatomical mechanism, existing treatment options, and indications. RESULTS: Iatrogenic blepharoptosis is a relatively common complication after double eyelid surgery, sometimes it is combined with other eyelid deformities such as sunken upper eyelid and wide double eyelid, which makes it difficult to repair. The etiology is mainly caused by improper adhesion of tissues and scars, improper removal of upper eyelid tissue, and injury of a link of levator muscle power system. Whether blepharoptosis occurs after double eyelid surgery by incision or suture, it should be repaired by incision. The principles of repair include surgical loosening of tissue adhesion, anatomical reduction, and repair of damaged tissues. The key is to use surrounding tissues or transplanted fat to prevent adhesion. CONCLUSION When repairing iatrogenic blepharoptosis clinically, appropriate surgical methods should be selected based on the causes and severity of the blepharoptosis, combined with treatment principles, in order to achieve better repair results.
Humans ; Blepharoptosis/surgery* ; Treatment Outcome ; Retrospective Studies ; Blepharoplasty/methods* ; Eyelids/surgery* ; Iatrogenic Disease ; Oculomotor Muscles/surgery*

OBJECTIVETo investigate the technique and therapeutic effect for correction of sunken eyes combined with ptosis.

METHODSIn order to adjust the levator muscle tension and the relationship between levator aponeurosis and tarsus plate, multiple individualized treatment was selected, including levator aponeurosis restoration, levator aponeurosis plication, or shorten, or combination. Then the orbital fat was transferred to the depressed area, or autologous fat particles were collected and injected into the depressed area within the orbital fat fascia. After the orbital septum fascia was restored, the incision was closed primarily.

RESULTS15 cases (30 eyes) were treated. 11 cases were followed up for 6-40 months (average, 9.5 months) with satisfactory cosmetic and functional result. No recurrence of ptosis happened.

CONCLUSIONSOne-stage correction of sunken eyes combined with ptosis can be achieved with autologous fat injection or orbital fat transposition. Good cosmetic and functional result can be achieved.

Adipose Tissue ; transplantation ; Aged ; Blepharoplasty ; methods ; Blepharoptosis ; surgery ; Eyelids ; Fasciotomy ; Humans ; Oculomotor Muscles ; surgery ; Orbit

OBJECTIVETo explore the feasibility of the treatment of upper eyelid sulcus using the expanded polytetrafluoroethylene implanted in orbit.

METHODSFrom July 2009 to April 2011, a total of 16 patients with upper eyelid sulcus were treated for recreating youthful periorbital appearance. To correct this kind of clinical characteristic, expanded polytetrafluoroethylene with different size were used as the orbital implant to restore the orbital contents and reinforce the bony support. upper eyelid sulcus was reversed effectively.

RESULTSWith average 2.5 year follow up, upper eyelid sulcus of 16 cases was reversed effectively. No postoperative complication related to globe or affected normal physical function was found.

CONCLUSIONSThe technique of orbital implantation with Expanded Polytetrafluoroethylene is beneficial for the treatment of the upper eyelid sulcus.

Blepharoptosis ; surgery ; Eyelids ; surgery ; Feasibility Studies ; Humans ; Orbit ; Polytetrafluoroethylene ; therapeutic use ; Postoperative Complications

OBJECTIVETo search an ideal method for treatment of severe blepharoptosis.

METHODSFifty-four eyes of 47 patients with severe blepharoptosis were undergoing for the treatment with a frontalis muscle complex flap, included in the frontalis muscle, orbicularis oculi muscle and SMAS membranes, to suspend the dropped eyelids.

RESULTSThe 54 eyes with severe blepharoptosis were successfully treated with the frontalis muscle complex suspension technique. Although the lagophthalmos in different degrees was shown in 3 months after the operation, it usually disappeared 6 months after the operation. The results were shown good appearance without recurrence.

CONCLUSIONThe above mentioned technique may be a good and effective method for treatment of the severe blepharoptosis, compared with the traditional technique.

Adolescent ; Adult ; Blepharoptosis ; surgery ; Child ; Female ; Humans ; Male ; Middle Aged ; Surgery, Plastic ; methods ; Treatment Outcome

OBJECTIVETo evaluate the clinical result of check ligament suspension for correction of congenital severe blepharoptosis.

METHODSSince Jan. 2010 to Nov. 2010, 15 eyes in 15 cases with congenital severe blepharoptosis were treated with the check ligament suspension. Palpebral aponeurosis was exposure by opening fascia palpebral during blepharoplasty. Palpebral aponeurosis was cut off about 5 mm above the tarsus. The check ligament was seen in the intermuscular space between the segment of levator and the anterior one third of superior rectus attached to the conjunctival fornix. Congenital blepharoptosis could be corrected by suturing the check ligament and levator palpebrae superior to the upper margin of tarsal plate with 3-0 silk thread. Double eyelid plasty was carried out in the end.

RESULTSThe follow-up period was 3-11 months with good cosmetic result. All the cases could close their eyes in 15 to 30 days with no complication.

CONCLUSIONSIn conclusion, this technique is quite successful in raising the level of the upper eyelid in severe congenital blepharoptosis. The check ligament moves in a similar direction as the natural movement of levator muscle, so both the postoperative static and dynamic appearance of the upper lid is more natural.

Adolescent ; Adult ; Blepharoplasty ; methods ; Blepharoptosis ; congenital ; surgery ; Female ; Humans ; Ligaments ; surgery ; Male ; Oculomotor Muscles ; surgery ; Young Adult

OBJECTIVETo investigate the role of releasing the fibrous bundles across the levator muscle between the medial canthus and lateral canthsus near the top of tarsus in the correction of the congenital blepharoptosis.

METHODSTwenty-seven patients with 40 eyes of blepharoptosis were undergoing the treatment. It was performed by releasing the fibrous bundles across the levator muscle between the medial canthus and lateral canthsus near the top of tarsus to correct the mild and moderate blepharoptosis. A further procedure can also be added to by folding the levator aponeurosis if necessary. In the severe blepharoptosis, the frontalis aponeurose flap may be applied for the suspension as well during the operation.

RESULTSOf the 40 eyes in 27 cases with mild, moderate and severe blepharoptosis were treated by using this method, with 38 eyes corrected satisfactorily and 2 eyes corrected mostly in the following-ups from 3 months to 1 year.

CONCLUSIONThe above mentioned technique may be a good, simple and effect method to corret congenital blepharoptosis.

Adolescent ; Blepharoplasty ; methods ; Blepharoptosis ; congenital ; surgery ; Child ; Eyelids ; surgery ; Facial Muscles ; Humans ; Oculomotor Muscles ; surgery ; Surgical Flaps

Strabismus fixus is very rare and the convergent form is rarely accompanied by blepharoptosis. We successfully treated one patient with high myopia whose convergent strabismus fixus, accompanied by blepharoptosis, became severe after cataract surgery. We report the case with a discussion of its pathology. We performed levator advancement operation, bilateral lateral rectus 11 mm resection, and bilateral medial rectus 8 mm recession. The suture was removed after maintaining temporary traction suture for 6 days. Blepharoptosis was completely corrected by postoperative 2 months. Esodeviation was 15PD, which was not increased compared with immediately after surgery. Satisfactory cosmetic outcome was obtained.
Aged ; Blepharoptosis/complications/*surgery ; Female ; Humans ; Myopia/complications ; Oculomotor Muscles/*surgery ; Ophthalmologic Surgical Procedures/methods ; Strabismus/complications/*surgery ; Treatment Outcome

Lyodura(R) is a commercial name of a cleaned, desantigenized, desenzymatized, rendered free of pyogenics, sterilized by gamma rays, and lyophilized dura. Frontalis suspension with Lyodura(R) was performed on a total of 16 patients (21 lids) of congenital ptosis with levator muscle function of 3mm or less in the ptotic lid. The follow-up period ranged from 2 to 39 weeks with a mean of 19.6 weeks. Postperative lid levels were judged good, fair, and poor. Good results occurred in 12 of 21 procedures (57.1%) and fair results in 6 of 21 procedures (28.6%). The summation of these two indicates an over all satisfactory result of 18 of 21 cases (85.7%).
Blepharoptosis/*congenital/therapy ; Child ; Child, Preschool ; Collagen/*therapeutic use ; Eyelids/surgery ; Humans ; Infant

OBJECTIVETo investigate the classification and surgical management of upper lid dematochalasis in middle-aged and elderly patients.

METHODS105 cases with upper lid dermatochalasis who underwent surgical treatment between May, 2000 to May, 2005 were retrospectively analyzed. The dermatochalasis was classified according to eye brow position, bulge contour and the skin amount of upper lid. The post-operative cosmetic result was also assessed.

RESULTSOf the 105 treated cases, the post-operative cosmetic result was assessed as very satisfactory in 77 (87%) cases, as satisfactory in 11(10%) cases, and as dissatisfactory in 3 (2%) cases.

CONCLUSIONSDermatochalasis in middle-aged and elderly patients has different types and should be treated with different surgical method.

Adult ; Blepharoplasty ; Blepharoptosis ; classification ; surgery ; Humans ; Middle Aged ; Retrospective Studies ; Skin Aging ; Treatment Outcome

Lacrimal fistula, a rare developmental disorder, may result from an abnormal budding of the epithelial cord of the lacrimal system. Most cases are unilateral, however, bilateral cases are still more rare, which are combined with other systemic diseases or accompanying disorders. This entity has so far been known only to ophthalmologist. We would like to illustrate lacrimal fistula in patients who were referred to our clinic for periorbital cosmetic surgery, such as blepharoptosis and epicanthus, from April 2005 to December 2007. Fistular orifices of all 6 patients were had been located inferomedial to medial canthi along the epicanthal fold. Out of 6 patients, 4 patients presented with unilateral lacrimal fistula; right side in 3 patients and left side in 1 patient, and bilateral lacrimal fistulas in 2 patients. Three cases were found to have positive connection between the nasolacrimal apparatus, and blind pouch type in 5 cases. Three out of six patients underwent fistulectomy with concurrent cosmetic periorbital surgery. In 2 patients who presented with connection with the nasolacrimal apparatus, fistulectomy and lacrimal sac or the common lacrimal canaliculi repair was performed as well. The remaining one patient with bilateral blind pouch type of lacrimal fistulas underwent a simple fistulectomy. There were no postoperative complications or any recurrences.
Blepharoptosis ; Cosmetics ; Fistula ; Humans ; Lacrimal Apparatus ; Lacrimal Apparatus Diseases ; Postoperative Complications ; Recurrence ; Surgery, Plastic