Purpose: Correction of myogenic ptosis has a dilemma of connecting the eyelid to frontalis muscle to enhance its levator muscle function.
Cases and Methods: The procedures consist of a routine levator muscle resection. Instead of discarding the resection aponeurosis, the tissue is reused as a suspension material. The aponeurosis is flipped upward and sutured to the lower edge of frontalis muscles. The lid height could be adjusted since the patient is under local anesthesia. Twelve eyes of myogenic ptois in eleven patients have corrected with this procedure with good results. All cases had an improvement of marginal reflex distance more than 2 mm. Lagophthalmos are minimal.
Discussion: Incorporation of aponeurosis to frontalis muscle aids in elevation of eyelid margin height. The procedure improves the inadequacy of a simple aponeurotic resection. It saves the complication of using a foreign body for suspension or donor tendon harvesting from other sites. It is much easier than advancing frontalis muscle down to tarsus. |
