Konjenital Miyojenik Pitoz Vakalarında Maksimum Levator Rezeksiyonu Prosedürünün Sonuçları
Amaç: Bu çalışmanın amacı, düşüklevator fonksiyonlu konjenital pitozis olgularında maksimum levator rezeksiyonu sonuçlarını değerlendirmektir. Yöntemler: Retrospektif olarak maksimum levator rezeksiyonu yapılan 30 olgunun 33 pitotik gözkapağı çalışmaya dahil edildi. Olguların 18’i erkek, 12’si kadın idi. Olguların ortalama yaşları 12.55±5.3 yıl (yaş aralığı, 4-26 yıl) idi. Tüm gözlerde dikey gözkapağı açıklığı, marjin reflex uzaklığı, levator fonksiyonu, üst gözkapağı cilt kıvrımı yüksekliği ölçüldü. Pitozis derecesi, gözkapağı hareketi ≤2 mm olduğunda ‘hafif’, 3 mm olduğunda ‘orta’ ve≥4 mm olduğunda ‘ağır’ olarak kaydedildi. Sonuç ve Yorum: Ortalama pitozis derecesi (dikey gözkapağı açıklığı) ameliyat öncesi 5.136mm, ameliyat sonrası 3. ayda 0.818 mm idi (p
Outcomes of Maximal Levator Resection Procedure in Cases of Congenital Myogenic Ptosis
Objective: This study aimed to evaluate the outcomes of maximal levator resection in cases of congenital myogenicptosis with poor levator function.Method: Thirty-threeptotic eyelids of 30 cases undergoing maximal levator resection were retrospectively included.There were 18 male and 12 female cases. The mean age of the cases was 12.55±5.3 years (range, 4-26 years). For alleyes, vertical palpebral aperture, margin reflex distance, levator functions, and upper eyelid crease height weremeasured. Ptosisseverity was “mild” when the eyelid elevation was ≤2 mm; “moderate” when the eyelid elevation was3 mm; and “severe” when the eyelid elevation was ≥4 mm. The mean age of the cases (18 males and 12 females) was12.55±5.3 years (range, 4-26 years).Results and Conclusion: The mean ptosis severity (vertical palpebral aperture) was 5.136 mm preoperatively and0.818 mm at the postoperative Month 3 (p
___
- 1. Gautam P, Adhikari R, Sharma BR. Etiopathogenetic
patterns of blepharoptosis in Western Nepal: an
Overview. Nepal J Ophthalmol. 2016; 8: 36-40.
- 2. Soo Hoo JR, Davies BW, Allard FD, Durairaj VD.
Congenital ptosis. Surv Ophthalmol. 2014; 59: 483-92.
- 3. Finsterer J. Ptosis: causes, presentation, and
management.Aesthetic Plast Surg. 2003; 27: 193-204.
- 4. Marenco M, Macchi I, Macchi I, et all. Clinical
presentation and management of congenital ptosis. Clin
Ophthalmol. 2017; 11: 453-63.
- 5. Gazzola R, Piozzi E, Vaienti L, Wilhelm BaruffaldiPreis
F. Therapeutic algorithm for congenital ptosis repair
with levator resection and frontalis suspension: results
and literature review. SeminOphthalmol. 2018; 33: 454-
60.
- 6. Mete A, Cagatay HH, Pamukcu C, et all. Maximal levator
muscle resection for primary congenital blepharoptosis
with poor levator function. Semin Ophthalmol. 2017; 32:
270-75.
- 7. Goel R, Kishore D, Nagpal S, Jain S, Agarwal T. The
relationship of amount of resection and time for recovery
of Bell's phenomenon after levator resection in
congenital ptosis. Open Ophthalmol J. 2017; 11: 24-30.
- 8. Bernardini FP, de Conciliis C, Devoto MH. Frontalis
suspension sling using a silicone rod in patients affected
by myogenic blepharoptosis. Orbit. 2002; 21: 195-8.
- 9. Lee JH, Kim YD. Surgical treatment of unilateral severe
simple congenital ptosis. Taiwan J Ophthalmol. 2018; 8:
3-8.
- 10. Lee JH, Aryasit O, Kim YD, Woo KI, Lee L, Johnson ON
3rd. Maximal levator resection in unilateral congenital
ptosis with poor levator function. Br J Ophthalmol. 2017;
101: 740-46.
- 11. Berke RN, Wadsworth JA. Histology of levator muscle
in congenital and acquired ptosis. AMA Arch Ophthalmol.
1955; 53: 413-28.
- 12. Collin JR. New concepts in the management of
ptosis.Eye (Lond). 1988; 2: 185-8.
- 13. Ünal M. Levator aponeurosis surgery.T Klin J
Ophthalmol. 1997; 6: 98-105.
- 14. Smith B, McCord CD, Baylis H. Surgical treatment of
blepharoptosis. Am J Ophthalmol. 1969; 68: 92-9.
- 15. Shore JW, Bergin DJ, Garrett SN. Results of
blepharoptosis surgery with early postoperative
adjustment. Ophthalmology. 1990; 97: 1502-11.
- 16. Press UP, Hübner H. Maximal levator resection in the
treatment of unilateral congenital ptosis with poor
levator function.Orbit. 2001; 20: 125-9.
- 17. Innocenti A, Mori F, Melita D, Dreassi E, Ciancio F,
Innocenti M. Evaluation of long-term outcomes of
correction of severe blepharoptosis with advancement of
external levator muscle complex: descriptive statistical
analysis of the results. In Vivo. 2017; 31: 111-5.
- 18. Nguyen CT, Hardy TG. Levator resection for
congenital ptosis: Does pre-operative levator function or
degree of ptosis affect successful outcome? Orbit. 2017;
36: 325-30.
- 19. Sar R, Yousuf S, Gupta Y. Surgical management of
congenital and aponeurotic ptosis – cosmetic outcome.
Austin J Clin Ophthalmol. 2014; 1: 1035.
- 20. Wu SY, Ma L, Huang HH, Tsai YJ. Analysis of visual
outcomes and complications following levator resection
for unilateral congenital blepharoptosis without
strabismus. Biomed J. 2013; 36: 179-87.
- 21. Abrishami A, Bagheri A, Salour H, Aletaha M, Yazdani
S. Outcomes of levator resection at tertiary eye care
center in Iran: a 10-year experience. Korean J
Ophthalmol. 2012; 26: 1-5.
- 22. Şimşek EB, Parlakgüneş S. Results of conjunctiva
Müller’s muscle resection and external levator resection
techniques for ptosis repair ptosis and results of
treatment options. OpthClinTher.2018; 2: 9.