Titre | Levator muscle function is increased by supra-maximal resection in BPES patients |
But | To study the efficacy, clinical and anatomical results of supra-maximal levator resection in BPES patients with severe congenital ptosis with poor levator function (LF). |
Méthodes | Eleven molecularly proven BPES patients underwent (supra-) maximal levator resection. Palpebral fissure (PF) height and LF was measured pre- and postoperatively. |
Résultats | All patients showed an excellent reduction in ptosis with a single intervention resulting in a clear visual axis. PF height improved from 3.3 ± 0.7 mm preoperatively to 7.1 ± 0.9 mm postoperatively (p value < 0.0001). Four patients underwent additional surgery because of cosmetic issues with eyelid height asymmetry. All patients showed a marked, consistent and lasting improvement in LF, going from 1.9 ± 0.9 mm preoperatively to a value of 7.4 ± 1.1 mm postoperatively (p value < 0.0001). This improvement could be attributed to the presence of a very long and thin tendon, as well as a striated muscle belly. This elongated aponeurosis inhibits the levator muscle from having sufficient impact on the vertical eyelid excursion. |
Conclusion | We demonstrated that (supra)-maximal levator resection performed in BPES patients not only results in good cosmesis in terms of ptosis reduction in the majority of cases, but also in a significant increase of the levator palpebrae superioris (LPS) function. An anatomical substrate was found to explain these findings. This is the first study to provide evidence of a marked increase in LF in BPES due to resection of the elongated tendon with reinsertion of the muscle belly. |
Nom | DECOCK |
Initiales | CE |
Institut | Ghent University Hospital |
Ville | ghent |
Nom | Kestelyn |
Initiales | P |
Institut | Ghent University Hospital |
Ville | Ghent |
Nom | Debaere |
Initiales | E |
Institut | Ghent University Hospital |
Ville | Ghent |
Nom | Leroy |
Initiales | BP |
Institut | Ghent University Hospital |
Ville | Ghent |
Nom | Claerhout |
Initiales | I |
Institut | Ghent University Hospital |
Ville | Ghent |