View abstract

This abstract is assigned to session Poster session in O'Bistro

Title

Levator muscle function is increased by supra-maximal resection in BPES patients

Purpose	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).
Methods	Eleven molecularly proven BPES patients underwent (supra-) maximal levator resection. Palpebral fissure (PF) height and LF was measured pre- and postoperatively.
Results	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.

Author 1

Last name	DECOCK
Initials	CE
Department	Ghent University Hospital
City	ghent

Author 2

Last name	Kestelyn
Initials	P
Department	Ghent University Hospital
City	Ghent

Author 3

Last name	Debaere
Initials	E
Department	Ghent University Hospital
City	Ghent

Author 4

Last name	Leroy
Initials	BP
Department	Ghent University Hospital
City	Ghent

Author 5

Last name	Claerhout
Initials	I
Department	Ghent University Hospital
City	Ghent