Clinical efficacy of conjoint fascial sheath suspension and frontalis muscle suspension in treating moderate or severe congenital ptosis and the effects on ocular surface and refractive status

Pan,Xuehong; Wei,Ting; Wang,Xiaodong; Xu,Chao

doi:10.3892/etm.2020.9053

Clinical efficacy of conjoint fascial sheath suspension and frontalis muscle suspension in treating moderate or severe congenital ptosis and the effects on ocular surface and refractive status

Authors:
- Xuehong Pan
- Ting Wei
- Xiaodong Wang
- Chao Xu
View Affiliations

Affiliations: Department of Medical Aesthetics, Yidu Central Hospital, Qingzhou, Shandong 262500, P.R. China, Department of Acupuncture and Moxibustion, Qingzhou Traditional Chinese Medicine Hospital, Qingzhou, Shandong 262500, P.R. China, Department of Burn and Plastic Surgery, Zibo Central Hospital, Zibo, Shandong 255036, P.R. China
Published online on: July 27, 2020 https://doi.org/10.3892/etm.2020.9053
Pages: 3278-3284
Copyright: © Pan et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Clinical efficacy of conjoint fascial sheath suspension and frontalis muscle suspension was explored in treating moderate or severe congenital ptosis and their effects on ocular surface and refractive status. A total of 75 patients with moderate or severe ptosis (108 eyes) treated in Yidu Central hospital from June 2014 to June 2019 were enrolled in this study, and divided into group A and group B. Group A was treated with conjoint fascial sheath suspension (n=38, 55 eyes), while group B was treated with frontalis muscle suspension (n=37, 53 eyes). The following data of the two groups were compared: General baseline data, total correction efficiency, satisfaction, and ocular surface after surgery, refractive status, and complications at three months after surgery. The two groups showed no significant difference in general data (P>0.05), but group A showed higher total correction efficiency and satisfaction, and less complications than those in group B (all P<0.05). In addition, the two groups had no difference in terms of ocular surface, tear break‑up time, or Schirmer test level after surgery (all P>0.05), and showed no refraction changes after surgery (P>0.05). In terms of refractive status and ocular surface, the two surgery methods are not very different, but in terms of efficacy, conjoint fascial sheath suspension is more advantageous than frontalis muscle suspension, and it brings less complications, and enjoys a higher satisfaction, so it is worthy of promotion.

View Figures

View References

1	Salman MS and Clark IH: Eyelid retraction in isolated unilateral congenital blepharoptosis. Front Neurol. 8(190)2017.PubMed/NCBI View Article : Google Scholar
2	Lee JH and Kim YD: Surgical treatment of unilateral severe simple congenital ptosis. Taiwan J Ophthalmol. 8:3–8. 2018.PubMed/NCBI View Article : Google Scholar
3	Allard FD and Durairaj VD: Current techniques in surgical correction of congenital ptosis. Middle East Afr J Ophthalmol. 17:129–133. 2010.PubMed/NCBI View Article : Google Scholar
4	Matayoshi S, Pereira IC and Rossato LA: Surgical treatment of congenital blepharoptosis. Rev Bras Oftalmol. 73:202–209. 2014.
5	Vyas KS, Kim U, North WD and Stewart D: Frontalis sling for the treatment of congenital ptosis. Eplasty. 16(ic12)2016.PubMed/NCBI
6	Quaranta-Leoni FM, Sposato S, Leonardi A, Iacoviello L and Costanzo S: Timing of surgical correction for the treatment of unilateral congenital ptosis: Effects on cosmetic and functional results. Orbit. 36:382–387. 2017.PubMed/NCBI View Article : Google Scholar
7	Zhou F, Ouyang M, Ma D, Liu G and Cheng H: Combined surgery for simultaneous treatment of congenital ptosis and coexisting strabismus. J Pediatr Ophthalmol Strabismus. 54:288–294. 2017.PubMed/NCBI View Article : Google Scholar
8	Paik JS, Kim SA, Park SH and Yang SW: Refractive error characteristics in patients with congenital blepharoptosis before and after ptosis repair surgery. BMC Ophthalmol. 16(177)2016.PubMed/NCBI View Article : Google Scholar
9	Mokashi AA, Stead RE and Abercrombie LC: Brow suspension using 3-0 Prolene. Eye (Lond). 25(819)2011.PubMed/NCBI View Article : Google Scholar
10	Arajy ZY: Open loop fascial sling for severe congenital blepharoptosis. J Craniomaxillofac Surg. 40:129–133. 2012.PubMed/NCBI View Article : Google Scholar
11	Farahat HG, Badawi NM, Mandour SS and Nage SA: Comparison of fasica lata and prolene suture in frontalis suspension surgery: Frontalis muscle suspension. Menoufia Med J. 30(502)2017.
12	Ahn TJ, Kim JH, Lee EI, Lew DH, Kim NH, Park RH, Kim KT and Song SH: Nonincisional conjoint fascial sheath suspension: A novel technique for minimally invasive blepharoptosis correction. Ann Plast Surg. 79:334–340. 2017.PubMed/NCBI View Article : Google Scholar
13	Pan E, Yu J, Zhang S, Nie Y and Li Q: Retrospective analysis of the effect of Hering's law on outcomes of surgical correction of ptosis. Ann Plast Surg. 80:242–244. 2018.PubMed/NCBI View Article : Google Scholar
14	Hwang K, Shin YH and Kim DJ: Conjoint fascial sheath of the levator and superior rectus attached to the conjunctival fornix. J Craniofac Surg. 19:241–245. 2008.PubMed/NCBI View Article : Google Scholar
15	Sokol JA, Thornton IL, Lee HB and Nunery WR: Modified frontalis suspension technique with review of large series. Ophthalmic Plast Reconstr Surg. 27:211–215. 2011.PubMed/NCBI View Article : Google Scholar
16	Holmström H and Santanelli F: Suspension of the eyelid to the check ligament of the superior fornix for congenital blepharoptosis. Scand J Plast Reconstr Surg Hand Surg. 36:149–156. 2002.PubMed/NCBI View Article : Google Scholar
17	Zuo L, Wang XX, Huang XY, Zhang JL and Du YY: A modified levator resection technique involving retention of the levator palpebrae superioris muscle suspension system for treatment of congenital ptosis. Aesthetic Plast Surg. 41:856–862. 2017.PubMed/NCBI View Article : Google Scholar
18	Yadav C, Saini A and Maji PK: Energy efficient facile extraction process of cellulose nanofibres and their dimensional characterization using light scattering techniques. Carbohydr Polym. 165:276–284. 2017.PubMed/NCBI View Article : Google Scholar
19	Farooq SM and Wani EA: Frontalis sling surgery: Silicon rod versus autogenous fascia lata in congenital ptosis. Int J Med Sci Public Health. 5(6)2016.
20	Lee YJ and Park DD: Frontalis transfer and closed silicone rod frontalis suspension. Aesthetic Plast Surg. 22:3–9. 2016.
21	Wilson ME and Johnson RW: Congenital ptosis. Long-term results of treatment using lyophilized fascia lata for frontalis suspensions. Ophthalmology. 98:1234–1237. 1991.PubMed/NCBI
22	Lin W, Xu Y and Ye FL: Comparative study on conjoint fascial sheath suspension and levator muscle resection for moderate or severe congenital ptosis. Int Eye Sci. 16:1193–1195. 2016.
23	Zhao YN, Ge HG and Shen QL: Comparative study on conjoint fascial sheath suspension and the simple frontalis muscle suspension for moderate or severe ptosis. Int Eye Sci. 17:1790–1792. 2017.
24	Xin LI, Lu MT, Jiang Y, Zhou WK, Zheng YM, Wu HY and Zhang L: Clinical study on conjoint fascial sheath suspension in the treatment of moderate and severe ptosis. J Reg Anat Operative Surg. 27:333–336. 2018.
25	Zhang F, Sun Y and Liu L: Clinical efficacy of conjoint fascial sheath of the levator and superior rectus attached to conjunctival fornix suspension surgery in treatment of severe blepharoptosis. Chin J Med Aesthet Cosmetology. 23:399–401. 2017.
26	Zhang D, Guo B and Cai W: Effect of frontal muscle aponeurosis flap suspension surgery for severe congenital ptosis in children. Minerva Pediatr. 71:358–361. 2019.PubMed/NCBI View Article : Google Scholar
27	Ma L, Mu X, Wang J and Liu H: Conjoint fascia sheath suspension for treatment of moderate to severe ptosis of the upper eyelid and observation of postoperative upper eyelid movement. Int J Clin Exp Med. 11:12531–12538. 2018.
28	Zhu T, Ye X, Xu P, Wang J, Zhang H, Ni H, Su Z and Ye J: Changes of corneal tomography in patients with congenital blepharoptosis. Sci Rep. 7(6580)2017.PubMed/NCBI View Article : Google Scholar