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Symmetry of Upper Eyelid Contour After Unilateral Blepharoptosis Repair With a Single-strip Frontalis Suspension Technique

Akaishi, Patricia, M.D.*; Galindo-Ferreiro, Alicia, M.D.; Cruz, Antonio A. V., M.D.*

Ophthalmic Plastic & Reconstructive Surgery: September/October 2018 - Volume 34 - Issue 5 - p 436–439
doi: 10.1097/IOP.0000000000001041
Original Investigations

Purpose: To analyze the upper eyelid contour of patients with unilateral congenital ptosis who underwent single-strip frontalis suspension.

Methods: The authors compared the upper eyelid shape of the right and left eyes of 10 patients who underwent unilateral frontalis suspension with a single strip of autogenous fascia. At a mean postoperative time of 10.1 ± 4.01 months, the image J software was used to measure the ratio between the nasal and temporal areas of the upper half of the palpebral fissure. The midpupil upper eyelid distance (MRD1) was also measured on the photos with the same software. The nonparametric Wilcoxon signed-rank test was used to compare the data.

Results: Postoperative MRD1 ranged from 2.5 to 4.7 mm (median = 3.8) on the affected side. The MRD1 for nonoperated eyelid ranged from 1.8 to 5.0 mm (median = 3.5). On the operated side, the temporal areas ranged from 50.3 to 85.7 mm2 (median 65.2) and nasal areas ranged from 41.5 to 72.3 (the median was 60.1). In the contralateral, nonoperated palpebral fissures, the temporal areas ranged from 42.7 to 94.3 mm2 (median = 54.5) and the nasal areas ranged from 36.8 to 86.1 mm2 (median 52.3). The T/N ratio distributions were almost identical between groups, ranging from 0.9 to 1.2 (median = 1.1) in the operated eyes and from 0.9 to 1.3 (median = 1.1) in the fellow eyes.

Conclusions: In autogenous fascia frontalis suspension procedures, the upper eyelid contour of the ptotic eyelids can be adequately normalized with a single area of traction on the tarsal plate.

A single strip of autogenous fascia provides excellent contour in poor levator function blepharoptosis.

*Division of Oculoplasty and Orbit, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil

Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain

Accepted for publication November 5, 2017.

The authors have no financial or conflicts of interest to disclose.

Address correspondence and reprint requests to Patricia Akaishi, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Hospital das Clínicas-Campus, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, 14049-900 São Paulo, Brazil. E-mail:

© 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.