Treatment of Congenital Myogenic Ptosis with Frontalis Suspension Surgery

Shaelva Lassa Sabatini, Riani Erna

Abstract


Ptosis repair is a challenging oculoplastic surgical procedure that requires correct diagnosis, thoughtful planning, thorough understanding of eyelid anatomy, experience, and good surgical technique. Ptosis can causefunctional problem and cosmetic issue.Thisstudywasreport 2 cases of congenital myogenic ptosis which were treated with frontalis suspension surgery.Case report,a 11-year old and a 20-year old girl came to our clinic with chief complain drooping in the upper eyelid RE since their childhood. Patients also complained difficulty of reading. The degree of ptosis during the day was the same. No diplopia, dysphonia, dyspnea, and dysphagia. VA 20/20 in the both eyes. Ocular motility were normal. MRD1 0 mm, FP 5 mm, no upper eyelid crease, LF 4 mm, no lagophthalmos, eyelid lag present, upper eyelid RE higher than LE in down gaze, and Bells phenomenon normal. Light reflex of pupil positive and diameter 3 mm in standard room illumination. Schimer test and TBUT were within normal. We diagnosed these patients with congenital myogenic ptosis RE and performed frontalis suspension surgery with autogenous tensor fascia lata.Postoperative, for first patient we got MRD1 2 mm and FP 7 mm. For second patient we got MRD14 mm and FP 9 mm. Patients had no complain drooping in the upper eyelid RE and difficulty of reading anymore.Frontalis suspension surgery is a way to treat patient with congenital myogenic ptosis who have poor levator function.

References


Skuta GL, Cantor LB, and Wessel JS. Periocular Malpositions and Involutional Changes. In: Orbit, Eyelids, and Lacrimal System. American Academy of Ophthalmology Section 7. San Fransisco. 2014-2015. p 201-213.

Collin JRO. Ptosis. In: A Manual of Systematic Eyelid Surgery. Third Edition. Elsevier. Butterworth Hainemann. London. 2006. p 85-114.

Thapa R, Karmacharya PC, Nepal BP. Etiological pattern of blepharoptosis among patients presenting in teaching hospital. JNMA J Nepal Med Assoc2006;45:218–22.

Rizvi SAR, Gupta Y, and Yousuf S. Evaluation of Safety and Efficacy of Silicone Rod in Tarsofrontalis Sling Surgery for Severe Congenital Ptosis. In: OpthalPlastReconstrSurg Vol 30, No 1. 2014. p 11-14.

Lovine MR. Frontalis Sling for Congenital Ptosis. In: Manual of Oculoplastic Surgery. Third Edition. Elsevier. Butterworth Heinemann. Philadelpia. 2003. p 107-112.

Betharia SM. Frontalis sling: a modified simple technique. Br J Crawford JS. Repair of ptosis using frontalis muscle and fascia lata: a 20-year review. Ophthalmic Surg1977;8:31–40.

Woo KI, Kim YD, and Kim YH. Surgical Treatment of Severe Congenital Ptosis in Patients Younger Than Two Years of Age Using Preserved Fascia Lata. Am J Ophthalmol 2014; 157: 1221-1226.

Wasserman BN, Sprunger DT, Helveston EM. Comparison of materials used in frontalis suspension. Arch Ophthalmol2001;119:687–91.


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