Sample records for blepharoptosis

  1. Acquired blepharoptosis

    NARCIS (Netherlands)

    Oosterhuis, HJGH


    A review is given of the aetiology and possible treatment of acquired (non-congenital) blepharoptosis, which is a common but not specific sign of neurological disease: The diagnostic categories of upper eyelid drooping are scheduled as (a) pseudo-ptosis due to a local process or overactivity of eye

  2. Surgical treatment for medically refractory myasthenic blepharoptosis

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    Shimizu Y


    Full Text Available Yusuke Shimizu,1 Shigeaki Suzuki,2 Tomohisa Nagasao,1 Hisao Ogata,1 Masaki Yazawa,1 Norihiro Suzuki,2 Kazuo Kishi1 1Department of Plastic and Reconstructive Surgery, 2Department of Neurology, Keio University School of Medicine, Tokyo, JapanPurpose: Currently, only a few reports have recommended surgery as a suitable treatment for blepharoptosis associated with myasthenia gravis. The present study aims to introduce our surgical criteria, surgical options, outcomes, and precautions for medically refractory myasthenic blepharoptosis. Patients and methods: Eight patients who failed to respond to at least 2 years of medical treatment and who underwent blepharoptosis surgery, from January 2008 to December 2011, were enrolled in this study. Medical records, photographs, and questionnaire results regarding postoperative status were evaluated. Of the eleven procedures performed, four involved frontal suspension, four involved external levator advancement, one involved nonincisional transconjunctival levator advancement, and two involved subbrow blepharoplasty with orbicularis oculi muscle tucking. The margin reflex distance improved postoperatively in seven patients. Results: Seven patients had very minimal scarring, and one had minimal scarring. Five patients showed no eyelid asymmetry, one had subtle asymmetry, and two had obvious asymmetry. Seven patients were very satisfied, and one patient was satisfied with the overall result. Postoperative complications included mild lid lag with incomplete eyelid closure, prolonged scar redness, and worsened heterophoria. No patient experienced postoperative exposure keratitis or recurrent blepharoptosis during the study period. Conclusion: Our results indicate that blepharoptosis surgery is effective for patients with myasthenia gravis, especially those with residual blepharoptosis despite multiple sessions of medical treatments. We recommend that neurologists and surgeons collaborate more systematically and

  3. Upper eyelid motility in blepharoptosis and in the aging eyelid

    NARCIS (Netherlands)

    R.J. Wouters; W.A. van den Bosch (Willem); H.G. Lemij (Hans); P.G.H. Mulder (Paul)


    textabstractPURPOSE. To study the metrics of lid saccades in blepharoptosis and to distinguish any differences in the dynamics of eyelid movements that are related to the cause of blepharoptosis and to aging. METHODS. The lid and vertical eye saccades of 7 patients with

  4. Elevator Muscle Anterior Resection: A New Technique for Blepharoptosis. (United States)

    Zigiotti, Gian Luigi; Delia, Gabriele; Grenga, Pierluigi; Pichi, Francesco; Rechichi, Miguel; Jaroudi, Mahmoud O; d'Alcontres, Francesco Stagno; Lupo, Flavia; Meduri, Alessandro


    Blepharoptosis is a condition of inadequate upper eyelid position, with a downward displacement of the upper eyelid margin resulting in obstruction of the superior visual field. Levator resection is an effective technique that is routinely used to correct aponeurotic ptosis. The anterior levator resection is the procedure of choice in moderate blepharoptosis when there is moderate to good levator muscle function, furthermore, with an anterior approach, a greater resection can be achieved than by a conjunctival approach. The authors describe a modification in the Putterman technique with a resection done over a plicated elevator, plication that was suggested by Mustardè. The technique has been named as elevator muscle anterior resection. The elevator muscle anterior resection inspires from the Fasanella-Servat operation by the use of a clamp, making the operation simple and predictable.

  5. Comparison of Blepharoptosis Correction Using Müller-aponeurosis Composite Flap Advancement and Frontalis Muscle Transfer

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    David Dae Hawan Park, MD, PhD


    Conclusions: In our study, we confirmed that Müller aponeurosis composite flap advancement and the frontalis transfer technique are both effective in the correction of severe blepharoptosis; our results showed no significant differences between the 2 techniques.

  6. Frontalis muscle flap suspension for the correction of congenital blepharoptosis in early age children.

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    Dianju Hou

    Full Text Available BACKGROUND: We aimed to report our successful use of frontalis muscle flap suspension for the correction of congenital blepharoptosis in early age children. METHODS: This retrospective study included 61 early age children (41 boys, 20 girls with an average age of 6 years (range, 3-10 years with congenital blepharoptosis who received surgery during the period from March 2007 to January 2011. There were 39 cases of unilateral blepharoptosis and 22 cases of bilateral blepharoptosis, thus a total of 83 eyes were affected. If patient had bilateral blepharoptosis, both eyes were operated on in the same surgery. Patients were followed for 3 months to 5 years. The procedure was performed without complications in all cases. RESULTS: The postoperative healing grade was good in 81 eyes (97.6%; the correction of blepharoptosis was satisfactory, the double eyelid folds were natural and aesthetic, the eyelid position and the curvature were ideal, and the eyes were bilaterally symmetrical. The postoperative healing grade was fair in 2 eyes (2.4%; blepharoptosis was improved compared with that before surgery. At discharge, lagophthalmos was noted in 10 eyes of which 4 cases resolved by the last follow-up. The remaining 6 cases were mild. Eleven eyes received reoperation for residual ptosis after the first surgery. The curvature of the palpebral margin was not natural in 4 eyes. These unnatural curvature possibly was caused by an excessively low lateral fixation point or postoperative avulsion. CONCLUSION: Frontalis muscle flap suspension under general anesthesia for the correction of congenital blepharoptosis in early age children can achieve good surgical results.

  7. [Suspending of blepharoptosis on temporalis fascia slings: our own experience]. (United States)

    Kokot, W; Półjanowski, P


    There are many procedures providing treatment of ptosis. In cases with palpebrae levator palsy, procedures involving mechanical suspension of palpebrae are used. Artificial and natural materials are used to suspend the lid. We describe surgical treatment of blepharoptosis using autogenous temporalis fascia sling. The sling is attached to the tarsus and spreads to the frontalis muscle. We have used this procedure in 12 cases. Full effect of functional elevation of palpebrae was achieved in 14 to 30 days after procedure. We did not encounter any significant complications due to this material. These operative modifications make this procedure more closely parallel to the normal eyelid dynamics and provide consistently good results for this difficult problem.

  8. Histological evaluation of levator palpebralis superior muscle in patients with congenital blepharoptosis

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    Sevda Söker


    Full Text Available The aim of this study was to examine levator palpebralis superior muscle histologically in patients with congenital blepharoptosis and to investigate the relationship between these findings and age, sex and degree of blefaroptosis in this patient group.Materials and methods: Levator muscle of 13 patients with congenital ptosis, who had applied to Dicle University Medical Faculty Ophthalmology Clinic and had undergone levator palpebralis superior muscle resection between january 2009-january 2010, has been examined histopathologically in Histology and Embriology Deparment. During preoperative period, ptosis amount, levator function (LF, tear functions, Bell’s phenomenon and jaw-winking phenomenon were evaluated. All patients underwent resection of levator palpebralis superior muscle. Received postoperative levator muscle was examined by light microscopy.Results: The average age of 9 (69.2% male and 4 (30.8% female cases were 10.61 ± 4.77 (4- 19 years. In histological examination, the quality and quantity of the levator muscle fibrils have been assessed. There was no relationship detected between histological features of levator palpebralis superior muscle and patient’s age and gender (p>0.05. Patients with weak levator palpebralis superior muscle were detected to have fatty degeneration histologically. The higher the levator palpebralis superior muscle function revealed decreased fatty degeneration and increased skeletal muscle fibrils.Conclusion: More ultrastructural studies in larger populations are needed to support the relationship between structure and function of levator palpebralis superior muscle in patients with congenital blepharoptosis.

  9. Reversible bilateral blepharoptosis following oxaliplatin infusion: a case report and literature review. (United States)

    Fanetti, Giuseppe; Ferrari, Laura A M; Pietrantonio, Filippo; Buzzoni, Roberto


    Oxaliplatin, a platinum analogue employed in the treatment of colorectal cancer and various other neoplasms, is characterized by a broad range of adverse events. Peripheral neuropathy is probably the most peculiar and clinically relevant toxicity associated with its use and can be distinguished into two types: acute and chronic neurotoxicity.We report a case of acute reversible bilateral palpebral ptosis and dyspnea without bronchospasm or laryngospasm which occurred at the end of the third administration of adjuvant oxaliplatin by infusion for stage III colon cancer in a 54-year-old woman. Chlorphenamine and hydrocortisone were administered with fast resolution of dyspnea and slight improvement of ptosis. Complete resolution with no sequelae occurred in one hour. No further recurrence of blepharoptosis was described during the following days. The subsequent cycles were prescribed at reduced dosage without acute complications.

  10. Comparison of Surgical Efficacy of Levator Muscle Short-ening and Modified Levator Aponeurosis Tucking in Treat-ing Minimal and Moderate Congenital Blepharoptosis

    Institute of Scientific and Technical Information of China (English)

    Chong Wang; Yanli Wang


    Purpose:.To evaluate the surgical effect of levator muscle shortening and levator aponeurosis tucking in treating minimal and moderate congenital blepharoptosis. Methods:.Clinical data of 28 patients (40 eyes) diagnosed with mide and moderate congenital blepharoptosis at our institution were retrospectively analyzed. Postoperative efficacy was eval-uated and statistically compared between these two techniques. Results:.During 14 months follow-up,.16 eyes with ptosis un-dergoing levator muscle shortening were treated,.3 with un-dercorrection of ptosis and 1 with overcorrection of ptosis.In patients receiving levator aponeurosis tucking,.16 eyes were cured and 4 with undercorrection of ptosis. Conclusion:.Both levator muscle shortening and levator aponeurosis tucking are safe and efficacious for correcting minimal and moderate congenital blepharoptosis.

  11. Blefaroptose em usuários de lentes de contato Blepharoptosis in contact lens wearers

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    Tiana Gabriela Burmann


    Full Text Available OBJETIVO: Investigar a freqüência de blefaroptose adquirida em usuários de lentes de contato. MÉTODOS: Avaliação prospectiva de 50 pacientes, usuários de lentes de contato, do Setor de Lentes de Contato do Serviço de Oftalmologia do Complexo Hospitalar Santa Casa de Porto Alegre, durante o período de abril a novembro de 2004. A distância reflexo-margem (MRD foi avaliada em 99 pálpebras de usuários de lentes de contato e para as 52 pálpebras de controle. Pacientes cuja medida da distância reflexo-margem se apresentou inferior a 2 mm ou com assimetria de distância reflexo-margem maior ou igual a 2 mm foram considerados portadores de blefaroptose. Foram avaliados o tipo de lente de contato utilizada e o tempo de uso das mesmas. RESULTADOS: Cinco pacientes apresentaram ptose, todos eles eram usuários de lentes de contato rígidas, um com ptose bilateral e quatro, unilateral. A distância reflexo-margem dos pacientes usuários de lentes de contato foi, em média, 0,88 mm inferior aos não usuários. Os valores de distância reflexo-margem foram progressivamente decrescentes nos grupos estudados: controles, usuários de lentes gelatinosas e de lentes rígidas. CONCLUSÃO: O estudo sugere que os usuários de lentes de contato possuem alteração dos valores de distância reflexo-margem, principalmente os que usam lentes rígidas.PURPOSE: To investigate the occurrence of acquired blepharoptosis in contact lens wearers. METHODS: Prospective analysis of 50 contact lens wearers being followed at the Contact Lenses Section of the Ophthalmology Service at the "Complexo Hospitalar Santa Casa de Porto Alegre" between April and November 2004. The margin reflex distance (MRD was evaluated for the 99 eyelids of contact lens wearers and for the 52 eyelids of controls. A patient whose measurement was less than 2 mm or with an assymetry of margin reflex distance greater or equal to 2 mm were considered with blepharoptosis. The contact lens type and

  12. Suspensory Materials for Surgery of Blepharoptosis: A Systematic Review of Observational Studies (United States)

    Pacella, Elena; Mipatrini, Daniele; Pacella, Fernanda; Amorelli, Giulia; Bottone, Andrea; Smaldone, Gianpaolo; Turchetti, Paolo; La Torre, Giuseppe


    Background Frontalis suspension surgery is considered the procedure of choice in cases of blepharoptosis. Among all the materials used in this type of surgery, ophthalmic and plastic surgeons prefer to use autologous Fascia Lata. However, during years, other autogenous and exogenous materials have been introduced. Objectives The aim of this study was therefore that of systematically reviewing the functional results and the rate of complications of different synthetic materials, as compared to autogenous Fascia Lata. The primary objective was to determine the rates of Successful Surgeries (SSs) of these materials. The secondary objective was to assess the onset of complications. The following materials were investigated: Fascia Lata, Mersilene, polytetrafluoroethylene (PTFE) and Silicon. Data Source and Methods Following the Prisma procedure, on January 30th, 2016 we used the following electronic databases to select the studies: MEDLINE and Scopus. Results The search strategy retrieved 48 publications that met the eligibility criteria of the systematic review. All studies were non-comparative. PTFE (n = 5) showed the best rate of SSs among the materials compared (statistically significant). Surgeries performed with autogenous Fascia Lata (n = 19) had a 87% rate of success those performed with Mersilene (n = 12)had 92% and those performed with Silicon (n = 17)88%. PTFE had the best outcome, with 99% success rate. As for complications, surgeries performed with PTFE had a higher rate of suture infections (1.9%) as compared to Fascia Lata, but lower incidence for all other complications. Conclusions Although most studies were good quality cohort studies, the overall quality of this evidence should be regarded as low due to their non-comparative design. Our data suggest that PTFE seems to be the most valid alternative material for frontalis suspension surgery, with low recurrence rates and good cosmetic and functional results. PMID:27631781

  13. Surgical anatomy and histology of the levator palpebrae superioris muscle for blepharoptosis correction

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    Đorđević Boban


    s crease was formed by the conjoined fascia including the fascia of the orbicularis muscle, the superficial layer of the orbital septum, and the aponeurosis of the LPS muscle, as well as the pretarsal fascia. Conclusion. The conducted study provided a valuable morphological basis for biomechanical and clinical considerations regarding blepharoptosis surgery. [Projekat Ministarstva nauke Republike Srbije, br. 175030

  14. Intra-eyebrow frontalis suspension using inverted Y-shaped short autogenous fascia lata for blepharoptosis with poor levator function. (United States)

    Shimizu, Yusuke; Nagasao, Tomohisa; Shido, Hirokazu; Fujii, Takako; Kato, Tatsuya; Aoki, Marie; Takada, Keiko; Kishi, Kazuo


    Frontalis suspension using autogenous fascia lata is a common procedure for blepharoptosis with poor levator function. However, donor-site morbidity associated with fascia lata harvest cannot be ignored. In conventional procedures, the required length of the fascia lata is usually >5-12 cm with a lateral thigh skin incision of approximately 5 cm or more. The present study introduces a new frontalis suspension procedure in which the required size (length and width) of the fascia lata and length of lateral thigh incision is much smaller. The harvested fascia lata is tailored to an inverted Y shape and the separated caudal legs are fixed to the tarsus while the cephalic end is grafted inside the eyebrow through a suborbital septum tunnel. In the present study, 11 patients who underwent the new procedure with a minimum of 6 months of follow-up were evaluated. The average length and width of the harvested fascia lata in unilateral ptosis cases were 2.85 and 0.89 cm, respectively. The average length of the lateral thigh incision was 1.25 cm. The margin reflex distance improved in all cases at 6 months postoperatively. The cosmetic result was graded as good to excellent in most of the patients. Trichiasis, widened donor scar, and eyebrow notch were noted as complications. The present method is a good alternative for the treatment of blepharoptosis with poor levator function. It potentially reduces donor-site morbidity as compared with conventional frontalis muscle suspension procedures using autogenous fascia lata.

  15. Palpebral position interdependence in blepharoptosis: comparison of the effect of instillation of 10% phenylephrine drop and digital lifting

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    Ivana Cardoso Pereira


    Full Text Available Purpose: To quantify and compare the effects of instillation with 10% phenylephrine and digital lifting on the contralateral upper eyelid of patients with involutional bilateral blepharoptosis. Methods: The present prospective clinical study involved patients with involutional bilateral blepharoptosis who underwent two tests: 1 digital lifting of the more ptotic eyelid and observation of the effect on the contralateral eyelid and 2 instillation of two drops of 10% phenylephrine in the more ptotic eye and observation of the effect on the contralateral eyelid. Patients were filmed before and 5, 10, and 15 min after instillation, and the resulting images were analyzed to obtain eyelid measurements. The results were tested using a linear mixed-effects model. Results: A total of 27 patients, ranging from 52 to 82 years of age (mean age 68.51 ± 8.21 years, 24 (88.88% of whom were women, were included in the present study. In eyes that received instillation, the marginal distance reflex-1 (MDR1 values increased from baseline (1.21 ± 0.60 mm until 10 min after instillation, then remained statistically unchanged until 15 min after instillation (2.42 ± 0.90 mm. Significant differences were observed in the contralateral eye of the group that underwent digital lifting (1.51 ± 0.53 mm - 1.63 ± 0.56 mm and in the contralateral eye of the group that underwent 10% phenylephrine instillation (1.38 ± 0.54 mm - 1.63 ± 0.56 mm; p=0.02 and p<0.01, respectively. Conclusion: In all eyes, 10% phenylephrine elevated the upper eyelid, with improved eyelid height at 10 min after instillation. Significant differences were observed in the height of the contralateral eyelid when compared before and after each intervention in each group; however, this difference was very small and nearly undetectable by conventional clinical evaluation in the digital lifting group. However, the 10% phenylephrine eye-drop test resulted in substantial changes in MDR1 values in the

  16. The surgical treatment of 379 cases of congenital blepharoptosis%先天性上睑下垂379例治疗体会

    Institute of Scientific and Technical Information of China (English)

    翟文娟; 潘叶; 唐东润; 孙丰源


    目的 应用不同术式治疗先天性上睑下垂,并对手术效果及其并发症进行评价.方法 自2002年6月至2007年10月间,共收治先大性上睑下垂患者379例(460只眼).其中重度上睑下垂300例(381只眼),中度上睑下垂47例(47只眼),轻度上睑下垂32例(32只眼).行阔筋膜悬吊术196例(246只眼),额肌瓣悬吊术104例(135只眼),提上睑肌缩短术47例(47只眼),提上睑肌腱膜折叠术32例(32只眼).结果 术后满意率为94.6%,好转率为5.0%,总有效率为99.6%.其中阔筋膜悬吊术手术满意率为91.9%,额肌瓣悬吊术满意率为95.5%,提上睑肌缩短术满意率为95.7%,提上睑肌腱膜折叠术满意率为96.9%.手术后有50只眼(10.9%)出现各种并发症,主要有额部血肿、暴露性角膜炎、矫正不全和上穹隆结膜脱垂,经相应处理后均好转.结论 对于提上睑肌无力的重度上睑下垂患者,采取阔筋膜悬吊术或额肌瓣悬吊术治疗,术后重睑自然,远期外观效果较好.提上睑肌力较好的轻度上睑下垂患者宜采取提上睑肌手术,术后重睑弧度自然,并发症少,是较理想的治疗方法.%Objective To investigate the various surgical techniques and their effects for correcting different types of blepharoptosis.Methods From June 2002 to October 2007,460 eyes of 379 eases patients with congenital blepharoptosis were received the surgical treatment.The patients with severe blepharoptosis were 300 cases(381 eyes),the patients with moderate blepharoptosis were 47 cases(47 eyes)and the patients with mild blepharoptosis were 32 cases(32 eyes).The surgical techniques included fascia lata sling with 196 cases(246 eyes),frontalis muscle flap suspension with 104 cases(135 eyes),superior levator muscle shortening with 47 cases(47 eyes)and superior levator aponeurosis folding with 32 cases(32 eyes).Results The satisfactory rate of the operations was 94.6%,5.0% patients were obtained better results,and the total effective rate was 99

  17. Analysis and treatment of an acquired blepharoptosis after blepharoplasty%上睑成形术后继发睑下垂的诊治与预防

    Institute of Scientific and Technical Information of China (English)

    李东; 谢宏彬; 李比; 薛宏宇; 秦荣生; 李健宁


    Objective To analyze the reasons of the blepharoptosis caused after blepharoplasty in order to search the proper method to correct the problem. Methods Eighteen patients of the blepharoptosis with 20eyes were undergoing for this study. The ptosis was determined with the measurement of the function of the levator muscle. The proper surgical technique selected was performed mainly to focus on the repair of the orbital septum and the levator muscle. All of the patients were followed up from 1 week to 4 years after the operation. Results Eighteen acquired blepharoptosis patients with 20 eyes were repaired after the analyzing the reasons. The results were satisfactory in 16 eyes,improved in 3 eyes and recurrent in 1 eye. Conclusions It is necessary to evaluate the function of the injured levator muscle and analyze the surgical-induced reasons of the ptosis eye before to repair the acquired ptosis. It is also reminded of the surgeons to pay more attention in order to prevent the occurrence of the problem when they do the blepharoplasty.%目的明确睑成形术后继发上睑下垂的病因,正确选择修复方法。方法根据术前、术中上睑提肌的功能状况以及术中所见上睑的解剖关系确定修复方案,修复的关键是眶隔整形和重建上睑提肌的生理解剖结构。结果临床治疗18例,20只眼。随访时间为1周~4年。16只效果良好,3只效果较满意,1只效果欠佳。结论术前、术中上睑提肌肌力测定对评判导致上睑下垂综合因素的作用具有定量诊断意义。以此为依据制定的修复方案经临床实践证明比较合理,并提出上睑成形术后继发上睑下垂的预防措施。

  18. 重度先天性上睑下垂不同术式的比较%Comparison of different operations for Severe Congenital Blepharoptosis

    Institute of Scientific and Technical Information of China (English)

    吴丽波; 蒋爱民


    Objective To analyze the effect of three operations for severe congenital blepharoptosis.Methods All 189 cases of severe congenital blepharoptosis, among which 80 cases(80 eyes)with improved suspension of frontal muscle flap, 39 cases(39 eyes)with frontal muscle suspension with allogeneic femoral fascia, other 70 cases(70 eyes)with supernormal shortening palpabralis. Results The frontal muscle suspension with allogeneic femoral fascia formed good double eyelid but with a high recurrence rate and the material was hard to get. Supernormal shortening palpabralis met the physiological requirement but easily leaded to lagophthalmos and conjunctiva procidentia. The improved suspension of frontal muscle flap hardly formed double eyelid but with a low recurrence rate, and the material was easy to get. Conclusions The three operations are all effective for Severe Congenital Blepharoptosis. The oculist should adopt the right operation according to the patients case and willing.%目的 分析异体阔筋膜悬吊术,超常量提上睑肌缩短术和改良的额肌瓣腱膜悬吊术治疗矫正重度先天性上睑下垂的效果.方法 对189例(189只眼)重度先天性上睑下垂住院病例进行手术治疗,其中改良的额肌瓣腱膜悬吊术80例,异体阔筋膜悬吊术39例,超常量提上睑肌缩短术70例.结果 三种手术方法均获得很好的治疗效果异体阔筋膜悬吊术,双重睑形成好,但复发率高,取材困难;超常量提上睑肌缩短术,手术合乎生理要求,但术后易发生睑裂闭合不全及结膜脱垂;改良的额肌瓣腱膜悬吊术,取材方便,复发率低,但双重睑形成差.结论 异体阔筋膜悬吊术,超常量提上睑肌缩短术和改良的额肌瓣腱膜悬吊术均能有效治疗重度先天性上睑下垂,临床上可根据患者的条件及意愿综合评估,灵活选择相应术式.

  19. Check ligament suspension for correction of congenital severe blepharoptosis%翼状韧带悬吊矫正先天性重度上睑下垂

    Institute of Scientific and Technical Information of China (English)

    潘贰; 张毓; 李琳; 沈绍勇; 王向阳; 王洪勇; 郝永生


    Objective To evaluate the clinical result of check ligament suspension for correction of congenital severe blepharoptosis. Methods Since Jan. 2010 to Nov. 2010, 15 eyes in 15 cases with congenital severe blepharoptosis were treated with the check ligament suspension. Palpebralis aponeurosis was exposured by opening fascia palpebralis during blepharoplasty. Palpebralis aponeurosis was cut off about 5 mm above the tarsus. The check ligament was seen in the intermuscular space between the segment of levator and the anterior one third of superior rectus attached to the conjunctival fornix. Congenital blepharoptosis could be corrected by suturing the check ligament and levator palpebrae superior to the upper margin of tarsal plate with 3-0 silk thread. Double eyelid plasty was carried out in the end. Results The follow-up period was 3-11 months with good cosmetic result. All the cases could close their eyes in 15 to 30 days with no complication. Conclusions In conclusion, this technique is quite successful in raising the level of the upper eyelid in severe congenital blepharoptosis. The check ligament moves in a similar direction as the natural movement of levator muscle, so both the postoperative static and dynamic appearance of the upper lid is more natural.%目的 探讨翼状韧带悬吊矫正重度先天性上睑下垂的临床效果.方法 2010年1~11月,应用翼状韧带悬吊法治疗先天性重度上睑下垂患者15例15只眼,按照切开重睑术术式,打开眶隔,在距睑板上缘5 mm处剪断上睑提肌腱膜进入到上睑提肌下层,向结膜上穹窿分离,在上直肌前1/3和上睑提肌之间找到翼状韧带,用3-0丝线同上睑提肌缝合于睑板上缘,悬吊矫正上睑下垂,缝合形成重睑.结果 经过3~11个月随访,15只眼矫正良好,眼裂均在15~30 d基本闭合,无其他并发症发生,重睑弧度形态自然,外观满意.结论 翼状韧带悬吊治疗重度先天性上睑下垂疗效可靠,用翼状韧带代替

  20. Improvement of frontal muscle-fascia suspension for blepharoptosis treatment%以额肌为动力治疗上睑下垂方法的改进

    Institute of Scientific and Technical Information of China (English)

    赵天兰; 余道江; 谢晓明; 张云涛; 徐妍; 陈琦; 吴浩荣


    目的 探索一种简便、实用的以额肌为动力治疗上睑下垂的方法的改进.方法 对22例不同程度的上睑下垂患者仍利用额肌作为动力,将分离的额肌筋膜直接固定于睑板上缘进行治疗.术中经重睑成形术切口将额肌筋膜与皮下组织充分游离,在眶上缘下横行切开额肌筋膜长约1.5 cm,在骨膜表面向上分离额肌筋膜,至眶上1.5 cm左右,不制作额肌筋膜瓣,然后将分离的额肌筋膜直接向下牵拉与睑板上缘睑上提肌腱膜缝合固定3~4针,并调整固定至张力适度为止,术中无需分离眼轮匝肌后隧道.结果 22例伤口均Ⅰ期愈合,睁眼时无抬眉、皱额表现,重睑外形佳,双眼对称,手术效果良好,患者满意.经3~6个月随访,无1例复发.结论 借用额肌作为动力,将额肌筋膜直接与睑板上缘缝合悬吊治疗上睑下垂,方法简便,疗效稳定,损伤小,并发症少.此方法可应用于额肌功能正常的各型上睑下垂患者.%Objective To introduce a new and practical method of treating blepharoptosis with direct suspension of the frontal muscle-fascia improvement. Methods 22 cases of blepharoptosis were corrected by direct suspension of the frontal muscle-fascia in which the dynamia still came from frontal muscle.Through double-fold eyelid incision, the frontal muscle-fascia was dissected from the subcutaneous tissue and a 1.5 cm length incision of the frontal muscle-fascia was cut under the supraorbital margin. And through the incision, the frontal muscle-fascia on the superficies of periosteum was dissected 1.5 cm to the upper margin of orbital, and then the frontal muscle-fascia was pulled down and fixed to the levator muscle aponeurosis directly by mattress sutures, with the tension being adjusted to a moderate degree. Results 22 cases of blepharoptosis were cured by primary healing with this method. The patients were followed up for 3 to 6 months with satisfactory results and no recurrence

  1. Suspensão ao músculo frontal com politetrafluoretileno para o tratamento da blefaroptose Frontalis suspension with polytetrafluorethylene for the treatment of blepharoptosis

    Directory of Open Access Journals (Sweden)

    Juliana Silvério


    Full Text Available OBJETIVO: Relatar a experiência com o uso do fio de politetrafluoretileno nas cirurgias de suspensão ao músculo frontal para correção de blefaroptose. MÉTODOS: Foram estudados todos os casos de blefaroptose grave submetidos à cirurgia pela técnica de suspensão ao músculo frontal como fio de politetrafluoretileno, no período de fevereiro de 2003 a abril de 2007. Foram realizadas 36 cirurgias em 23 pacientes, a média de seguimento foi de 15,8 meses (variando de 3 a 36 meses. A técnica cirúrgica utilizada foi a descrita por Fox. RESULTADOS: Entre as causas de blefaroptose foram encontradas: congênita em 20 (86,95% pacientes, blefarofimose em 2 (8,69% pacientes e traumática em 1 (4,35% paciente. Na primeira semana de pós-operatório, 6 (26,08% pacientes referiram assimetria palpebral, 4 (17,39% notaram edema local, 3 (13,04% pacientes apresentaram granuloma no local do fio e 1 (4,35% paciente apresentou celulite facial na região frontal unilateral. Após 3 meses de seguimento, 3 (13,04% pacientes referiram assimetria palpebral, e em 1 (4,35% paciente persistia o granuloma. CONCLUSÃO: O politetrafluoretileno - Modelo CV3, 6.0 (Gore-Tex®; W.L. Gore & Associates Inc, Flagstaff, AZ, EUA é um material adequado com bons resultados funcionais (86,9%, baixos índices de complicação (4,35% e insatisfação (13,4%, podendo ser uma alternativa em relação à fáscia lata, na cirurgia de suspensão ao frontal para tratamento de ptose palpebral grave.PURPOSE: To evaluate the functional results and complications of the use of expanded polytetrafluoroethylene in frontalis suspension surgery for the treatment of blepharoptosis. METHODS: Frontalis suspension procedure with polytetrafluoroethylene was performed between 2003 and 2007 on 23 patients (36 eyes with blepharoptosis. An average follow-up time was 15.8 months (range, 3 to 36. Surgical technique used was described by Fox. RESULTS: The causes of blepharoptosis found were: congenital in

  2. 改良的额肌瓣悬吊治疗上睑下垂%Modified treatment of blepharoptosis with the suspension of scalene frontal muscle flap

    Institute of Scientific and Technical Information of China (English)

    封必钊; 卢学军; 王光军; 程宏宇


    目的为了减少额肌损伤,保证额肌瓣的收缩力,提高上睑下垂的治疗效果。方法重睑成形术切口,切开皮肤、皮下及眼轮匝肌。于眼轮匝肌深面向上直接分离额肌深层,然后再于眶缘额肌与眼轮匝肌交界处进入额肌浅层分离达眉上1.5~2 cm,纵行切开肌瓣两侧,外侧应为内侧的1/3。结果临床应用治疗38例59只眼,除1例因外伤致左眼上睑下垂,术后效果欠佳外,其余37例58只眼治疗效果满意。结论本法减少了额肌瓣外侧血管神经损伤,由于增加蒂部宽度,增强了额肌瓣的收缩力。适用于中,重度上睑下垂的治疗。%Objective To reduce the damage of frontal muscle,guarantee the contractility of the for rntal muscle flap and better the therapeutic effects of the blepharoptosis.Methods The incision of plastic operation of double eyelids is to cut the skin ,hypodermis and orbicular muscle of eye to separate directly the deep layer of frontal muscle upward from the orbicular muscle of eye and then reach the superficial layer of the frontal muscle at the juncture of the orbicular muscle and the orbicular muscle of eye with the separation about one and half to two centimeters above the eyebrow,to cut the both sides of the flap vertically with the ratio of one to three of the length of outer part and inner part.Results Thirty-eight cases of blapharoptosis with fifty-nine eyes had been clinicary treated.Except one case failed to get good effect because of an injury in the left eye, thirty-seven cases with fifty-eight eyes showed satisfactory therapeutic effects. Conclusions This therapeutic method can reduce the damage of outer blood vessel and nerves of the frontal muscle flap,improve the contractility of the flap and is suitable to the therapy of moderate and severe blepharoptosis.

  3. Surgical desensitisation of the mechanoreceptors in Müller's muscle relieves chronic tension-type headache caused by tonic reflexive contraction of the occipitofrontalis muscle in patients with aponeurotic blepharoptosis. (United States)

    Matsuo, Kiyoshi; Ban, Ryokuya


    Proprioceptively innervated intramuscular connective tissues in Müller's muscle function as exterior mechanoreceptors to induce reflex contraction of the levator and occipitofrontalis muscles. In aponeurotic blepharoptosis, since the levator aponeurosis is disinserted from the tarsus, stretching of the mechanoreceptors in Müller's muscle is increased even on primary gaze to induce phasic and tonic reflexive contraction of the occipitofrontalis muscle. It was hypothesised that in certain patients with aponeurotic blepharoptosis, the presence of tonic reflexive contraction of the occipitofrontalis muscle due to the sensitised mechanoreceptors in Müller's muscle, can cause chronic tension-type headache (CTTH) associated with occipitofrontalis tenderness. To verify this hypothesis, this study evaluated (1) what differentiates patients with CTTH from patients without CTTH, (2) how pharmacological contraction of Müller's smooth muscle fibres as a method for desensitising the mechanoreceptors in Müller's muscle affects electromyographic activity of the frontalis muscle, and (3) how surgical aponeurotic reinsertion to desensitise the mechanoreceptors in Müller's muscle electromyographically or subjectively affects activities of the occipitofrontalis muscle or CTTH. It was found that patients had sustained CTTH when light eyelid closure did not markedly reduce eyebrow elevation. However, pharmacological contraction of Müller's smooth muscle fibres or surgery to desensitise the mechanoreceptor electromyographically reduced the tonic contraction of the occipitofrontalis muscle on primary gaze and subjectively relieved aponeurotic blepharoptosis-associated CTTH. Over-stretching of the mechanoreceptors in Müller's muscle on primary gaze may induce CTTH due to tonic reflexive contraction of the occipitofrontalis muscle. Therefore, surgical desensitisation of the mechanoreceptors in Müller's muscle appears to relieve CTTH.

  4. 单切口额肌上睑SMAS瓣经眶隔后悬吊治疗上睑下垂%Single-incision frontalis muscle and SMAS flap suspension through the orbital septum for blepharoptosis

    Institute of Scientific and Technical Information of China (English)

    王卫峻; 张路; 王炜


    Objective To study the indications and practices of single-incision frontalis muscle and SMAS flap ( SIFSF) suspension through orbital septum for blephroptosis ( modified Song' s multi-incision technique). Methods From July 1993 to November 2009, 148 cases with 215 eyelids blepharoptosis were treated. Among them , the SIFSF was applied in 81 cases with 121 eye, including serious and recurded blepharoptosis,Horner's Syndrome, Marcus Gunn jaw-winking syndrome, Congenital Blepharophimosis syndrome and Treacher-Collins Syndrom with blepharoptosis. Results The SIFSF suspension for blepharoptosis which was avoided an incision under the eyebrow. It is not only to treat upper eyelid ptosis but also can rebuild the aesthetic double eyelid. Totally 49 cases with 69 blepharoptosis were followed up for four weeks to ten years post operatively, excellent results were received in 30 cases with 45 eyelids, good in 17 cases and 22 eyelids, poor in 2 cases and 2 eyelids. The successful rate was 97% . The postoperative complications such as cornea ulcer happened in 1 case , conjunctival prolapse in 2 cases, eyelid inversion in 1 case and hematoma in 2 cases. All cases of complication were treated by conservative treatment except 1 case with upper eyelid inversion which was treated by a surgery. Also the second stage operation were taken for two cases with poor results. Conclusion The SIFSF suspension through orbital septum for blepharoptosis can effectively treated serious and recurded upper eyelid ptosis , and several syndromes with blepharoptosis. It could avoid an incision under the eyebrow and reconstruct a similar levator dynamic function , with a good functional and aesthetic results for blepharoptosis.%目的 总结单切口额肌上睑SMAS瓣经眶隔后悬吊治疗上睑下垂的适应证及手术方法.方法 取上睑重睑皱襞切口,SIFSF悬吊治疗上睑下垂,重建上睑提升动力通道近似上睑提肌滑行路径.自1993年7月至2009年11

  5. Clinical observation different operative method in treatment of children with congenital blepharoptosis%不同手术方法治疗儿童先天性重度上睑下垂的临床观察

    Institute of Scientific and Technical Information of China (English)



    目的 观察不同的手术方式矫治儿童重度先天性上睑下垂的治疗效果.方法 36例47眼,应用额肌筋膜瓣悬吊术组18例24眼,自体阔筋膜悬吊术组18例23眼,比较两组术后疗效.结果 随访6个月,满意率比较两组无明显差异性(P>0.05).结论 两种方法各有优缺点,对治疗儿童重度上睑下垂均有效.%Objective To observe the clinical effect of different surgical treatment in children severe congenital blepharoptosis. Methods Totally 36 cases of 47 eyes,used forehead myofascial disc sling operation group 18 cases of 24eye,rich autologous fascia of sling operation 18 cases 23 eye,Compared postoperative curative effect of two groups. Results Follow - up 6 months,satisfaction rate was compared between the two groups has no obvious difference. Conclusions Two kinds of method have its advantages and disadvantages,to treating children severe blepharoptosis are valid.

  6. Modified shortening of levator palpebrae superioris muscle for moderate and severe congenital blepharoptosis%改良上睑提肌缩短术治疗中度和重度上睑下垂

    Institute of Scientific and Technical Information of China (English)

    沈海燕; 杨军; 杨群; 钱云良


    目的 探讨应用改良上睑提肌缩短术治疗中、重度先天性上睑下垂的疗效.方法 对30例中、重度先天性上睑下垂患者(包括2例上睑下垂术后欠矫和复发患者),采用联合睑板切除的上睑提肌缩短术.术中睑板切除量根据睑板的宽度设计,上睑提肌切除量=(上提量-睑板切除宽度)× (4~5) mm.并分离睑结膜和上睑提肌,切除一定量的睑结膜以防止结膜脱垂,对术后效果进行随访观察.结果 30例除3例矫正不足外,余均获得良好上提效果,上睑缘弧度自然,无严重并发症,仅少数患者早期有轻度睑裂闭合不全.结论 改良上睑提肌缩短术适用于中、重度先天性上睑下垂患者及上睑下垂术后欠矫的患者,在矫正畸形和改善外观方面均能达到良好的效果.掌握手术操作要点,有助于在功能和外形上取得满意效果.%Objective To discuss the effect of an advanced technique by shortening the levator palpebrae superioris muscle in treatment of moderate and severe congenital blepharoptosis. Methods 30 cases of moderate and severe blepharoptosis (including 2 cases of recurrent ptosis) were treated by shortening the levator palpebrae superioris associated with resection of tarsus. Removal portion of tarsus and levator palpebrae superioris muscle was designed according to the width of tarsus and the severity of blepharoptosis. Tarsus and levator palpebrae superioris muscle and conjunctiva palpebrae were resected on the basis of above design. The results of postoperation were followed up. Results Among the 30 cases, except for undercorrection in 3 cases, all others had a good outcome. Eyelid was raised to normal level by this technique with a natural eyelid contour. Only some presented a slight dysraphism in the early stage of postoperation,and no other severe complications occurred. Conclusions Shortening of the levator palpebrae superioris muscle can be applied to treat moderate and severe congenital

  7. The effectives of releasing the fibrous bundles across levator muscle in double eyelid blepharoplasty with mild blepharoptosis%限制韧带松解在矫正先天性轻度上睑下垂的重睑术中的应用

    Institute of Scientific and Technical Information of China (English)

    任冲; 马力; 胡晓根; 马海欢


    目的:在重睑术前应重视先天性轻度上睑下垂的诊断并探讨应用限制韧带松解术在治疗先天性轻度上睑下垂中的临床意义.方法:对临床要求重睑的患者,通过“抬眉/额纹增多、仰颏、抬眼费力”三联症初步判断是否同时有轻度上睑下垂的存在;对确诊为先天性轻度上睑下垂患者,通过单纯松解限制韧带即可矫正大部分患者,不完善者加行上睑提肌腱膜缩短术.结果:本组2 3例3 3只眼,19例26只眼在重睑术中行单纯限制韧带松解术,4例7只眼行限制韧带松解术+上睑提肌腱膜折叠缩短术.随访3个月~2年,所有患者对上睑下垂矫正效果均满意,左右对称,外形自然.抬眼明显轻松,无复发.结论:在重睑术前应重视对先天性轻度上睑下垂的诊断,限制韧带松解术是治疗先天性轻度上睑下垂的首选方法,对于大部分患者可达到完全矫正的效果,且形态自然,不易复发.%Objective To stress the importance of diagnosis of mild blepharoptosis before double eyelid blepharoplasty and to investigate the role of releasing the fibrous bundles across levator muscle in correction of mild blepharoptosis. Methods For patients seeking double eyelid blepharoplasty, tne diagnosis of mild blepharoptosis was based on the three symptoms including " lifting eyebrow with more frontal wrinkes, lifting jawjifting upper eyelid with efforts". For patients with mild blepharoptosis, simply releasing the fibrous bundles across levator muscle could correct most mild blepharoptosis. A further procedure can be added to shortening the levator aponeurosis if necessary. Results Of the 33 eyes in 23 cases, 26 eyes in 19 cases received simple release of the fibrous bundles across levator muscle,7 eyes in 4 cases received both releasing and shortening the fibrous bundles across levator muscle. The follow-up ranged from 3 months to 2 years. All patients gained complete recovery, symmetry,and natural appearance

  8. Preceding Operation of Suspensory Ligment of the Fornis for correction of Congenital Blepharoptosis%用穹窿悬韧带前徙法矫正先天性上睑下垂临床研究

    Institute of Scientific and Technical Information of China (English)

    凃惠芳; 杜薇; 赵敏; 陆秀兰; 喻长泰


    目的 探讨矫正先天性上睑下垂简单、无损伤、效果好的手术方式.方法 收集2014年9月至2015年3月在武汉爱尔眼科医院应用穹窿悬韧带前徙矫正先天性上睑下垂74例,其中男33例,女41例,年龄2~60(平均16.5岁),单眼50例,双眼24例.全麻或局麻下,按标记的重睑线切开眼睑皮肤,打开眶膈,在提上睑肌复合体与结膜间向上穹窿分离,找到隙间筋膜鞘即穹窿悬韧带后,将其用缝线固定于睑板前表面,依眼睑位置,调整缝线高度,至满意为止,然后关闭创口.结果 74例的94只手术眼,术后上睑均矫正到满意位置,双侧对称,无暴露性角膜疾患发生.在术后观察期内,上睑位置稳定.结论 此法利用了提上睑肌复合体和上直肌共同的上转功能,较好地矫正各种程度的先天性上睑下垂,不截除肌肉,不添加组织或材料,且疗效稳定可靠.该法是目前矫正先天性上睑下垂较理想的一种手术方式.%Objective To investigate the simplest、harm minimazation and good effect surgical option for congenital blepharoptosis.Methods 17 patients affected by simple congenital bleapharoptosis were operated using the technique of suspending the eyelid to the check ligament from Sep.15th,2014 to March.15th,2015.Among the patients,33 were male,41 were female,the patients ranged from 2-60 years old with a mean age was 16.5,50 patients were unilateral and 24 were bilateral.Surgeries were under general anaesthesia or local anaesthesia,After incision of the skin and underlying orbicularis muscle,the orbit septurm was opened,Dissection was made between the levatoraponeurosis complex and conjuctival up to the fornix,when the check ligament of the superior conjunctival fornix was verified,it was sutured to the tarsus,adjusting the height of the suture until the height and contour of the eyelid was satisfied,closed the skin.Results 74 Patient(94 eyes) were operated,after the surgery,all patients got a satisfactory

  9. Shortening of levator muscle for patients with severe congenital blepharoptosis in different ages and different muscle strength%上睑提肌缩短术治疗不同年龄不同肌力的重度先天性上睑下垂的疗效观察

    Institute of Scientific and Technical Information of China (English)

    叶琳; 刘桂琴; 贾惠莉


    Objective To observe the surgery effect of shortening of levator muscle for patients of severe congenital blepharoptosis in different ages and different muscle strength.Methods There were 32 cases(40 eyes) of severe congenital blepharoptosis from Jan.2008 to Aug.2009.All of them had undergone shortening of levator muscle.The effects one year after surgery were divided into good,still good,bad and over correction.All patients were divided into 2 groups by age (0 ~ 5 years,6 ~ 25 years ),and into 2 groups by levator muscle strength ( < 2 mm,≥ 2 mm).Comparison between different age groups and different muscle strength groups by x2 test.Results There was significant difference between 0-5 year-old group and 6-25 year-old group (P < 0.05 ).There was significant difference between different muscle strength groups ( P < 0.05).Conclusion Patients with severe congenital blepharoptosis shoud be treated with surgery of shortening of levator muscle of upper lid after 6 years old,as long as visual function is normal.Effect of shortening of levator muscle surgery is better for patients of severe congenital blepharoptosis whose muscle strength ≥2 mm.%目的 探讨上睑提肌缩短术对于不同年龄、不同肌力的重症上睑下垂的远期治疗效果.方法 观察2008年1月至2009年8月在我院进行治疗的重症上睑下垂32例(40眼)术后1年的效果,所有患者均采用上睑提肌缩短术治疗,手术效果分为良好、尚好、差及过矫4级.所有患者按年龄分为两组(0~5岁组及6~25岁组),并且按上睑提肌肌力又分为两组(<2mm,≥2 mm).结果 不同年龄组之间比较:达Ⅰ级疗效的,两组差异有统计学意义(P<0.05);不同肌力组之间进行比较:达Ⅰ级疗效的,两组差异有统计学意义(P<0.05).结论 对于重度先天性上睑下垂,只要不影响视功能,可等待至6岁以后采用上睑提肌缩短术治疗,对肌力≥2 mm者的疗效优于肌力<2mm者.上睑提肌缩短术

  10. Clinical effect and safety of the technique by shortening the levator palpebrae superioris muscle and the musculus frontalis flap suspension surgery for morderate congenital blepharoptosis%上睑肌缩短术和额肌瓣悬吊术矫治先天性中度上睑下垂临床疗效和安全性

    Institute of Scientific and Technical Information of China (English)

    王雪燕; 邹娟; 徐玲; 赵建敏


    Objective To investigate the clinical effect and safety of the technique by shortening the levator palpebrae superior muscle and the musculus frontalis flap suspension surgery for morderate congenital blepharoptosis. Methods One hundred and eight patients with morderate congenital blepharoptosis were analyzed and divided into two groups randomly to receive different operative treatments from May 2010 to May 2012. Fifty-six patients were selected and operated by shortening the levator palpebrae superioris musle (Group A), while 52 patients were operated with frontal muscle suspension (Group B). The clinical effect and adverse reactions were compared between the two different operation modes for morderate congenital blepharoptosis. Results In group A, 53 pa- tients were well corrected after surgery in Group A, and the effect rate was 94.6%, which was higher than that in Group B (71.2%), with significantly difference between the two groups (P<0.05). Most patients' vision were improved to varying degress acuity,the incidence of complications in Group A and Group B were 6.25% and 23.1%, respectively, with significant difference (P<0.05). Conclusion The method of shortening the levator palpebrae superior muscle can be taken as first choice for congenital blepharoptosis.%目的 观察上睑肌缩短术和额肌瓣悬吊术矫治先天性中度上睑下垂患者的临床疗效和安全性.方法 对我院2010 年5 月至2012 年5 月收治的108 例先天性中度上睑下垂患者进行手术治疗,其中56 例采用上睑肌缩短术治疗(A组),52 例采用额肌瓣悬吊术治疗(B组),比较两种不同手术术式矫治的临床疗效以及不良反应发生情况.结果 A组中53 例患者的手术治疗效果较好,有效率为94.6%,B组有效率为71.2%,两组间的差异具有统计学意义(P<0.05).大部分患者术后视力均有不同程度提高,但A组术后并发症的发生率(7.1%)明显低于B组(23.1%),其差异具有统计学意义(P<0.05).结论 上

  11. 87例先天性上睑下垂手术矫正临床分析%Clinical Analysis of 87 Cases of Surgical Correction of Congenital Blepharoptosis

    Institute of Scientific and Technical Information of China (English)



    目的:比较提上睑肌缩短+前徙术、额肌瓣悬吊术对先天性上睑下垂的矫正效果。方法:采取单纯重睑切口,对87例患者中的54例共66眼行提上睑肌缩短+前徙术,33例共43眼行额肌瓣悬吊术,术后1、6、12月各随访1次,记录视力,术眼上睑缘位置、双眼睑裂对称性,睑裂闭合不全程度、有无倒睫、成角畸形。结果:79例患者经1次手术矫正满意,6例患者矫正良好,2例患者第一次手术矫正不足,再次手术矫正满意,无矫正过度及无效病例。结论:两种手术方法效果肯定,提上睑肌缩短术符合生理解剖位置,术后睑裂闭合不全程度较轻并可逐渐消失,大部分患者可以选择,但是少数患者欠矫。额肌瓣悬吊术后睑裂闭合不全程度较重,且永久存在,少部分患者出现出血、伤口裂开等并发症,但是只要术后观察护理得当,可避免并发症发生。%Objective: To compare the corrective effects of shortening and advancement of levator palpebrae superioris muscle and frontal muscle flap suspension surgery for congenital blepharoptosis. Methods:Frontal muscle flap suspension surgery was adopted on 43 eyes of 33 patients and shortening and advancement of levator palpebrae superioris muscle was used on 66 eyes of 54 patients among 87 cases by pure double eyelid incision. Follow-up visits of each patient were paid in the first, the sixth, the twelfth month after the surgery for taking records of visual acuity, position of upper eyelid skin edge of the surgery eye, the symmetry of both eyes' palpebral fissure, the level of palpebral fissure dysraphism, and any trichiasis and angulation deformity. Results: 79 patients got satisfying effects and 6 patients got fine effects after the first surgery. 2 patients got insufficient correction after the first surgery and then got satisfying effects by the second time. There is no overcorrection and nullity. Conclusion

  12. Comparison of Two Methods for Upper Lid Fascia Lata Sling in Congenital Blepharoptosis: a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Abbas Bagheri


    Full Text Available

    PURPOSE: To compare the results of two different methods of upper lid sling with autogenous fascia lata in the treatment of congenital ptosis. METHODS: In a randomized clinical trial, patients with congenital upper lid ptosis and poor levator function (< 4mm were randomly assigned to two different methods of upper lid sling: group A, bitriangular fascia sling (modified Crawford method and group B, monotriangular fascia sling (modified Fox method. RESULTS:  This study included 30 upper eyelids (15 eyelids in each surgical group of 19 patients (8 unilateral and 11 bilateral cases with congenital ptosis. Mean increase in eyelid fissure height was 2.7±2.3 mm in group A and 3.4±2.2 mm in group B, respectively. Change in eyelid fissure in both groups was significant (P < 0.001, paired t-test but intergroup difference was not (P=0.4, independent sample t-test. Early complications such as corneal epithelial defects and entropion, and late complications such as undercorrection were comparable in the two groups. No patient experienced recurrent ptosis requiring reoperation in either group. CONCLUSION:  The monotriangular method of upper lid fascia sling can be used instead of the more popular bitriangular method. Advantages include less need for fascial tissue, less periocular scar formation and a shorter period of anesthesia.


    Institute of Scientific and Technical Information of China (English)

    范希玲; 宋建良; 田枫; 郑群



  14. 提上睑肌短缩术矫治重度上睑下垂临床分析%Analysis of application of levator muscle resection on severe blepharoptosis patients

    Institute of Scientific and Technical Information of China (English)

    朴荣利; 赵自然; 张可佳


    目的 证明提上睑肌短缩术治疗重度上睑下垂的可行性及疗效,并与其他手术方法进行比较,为临床选择合理手术方法提供理论及临床依据。方法 将32例已施行上睑下垂手术的病人按照不同的手术方式分为:提上睑肌短缩术组24例、额肌瓣悬吊术组8例。通过上睑下垂矫正术后上睑缘位置、眼睑闭合程度、上睑迟滞现象及暴露性角膜炎的发生情况,对病人进行至少6个月的随访观察,比较各组的手术疗效。结果 提上睑肌短缩术组治愈率与额肌筋膜瓣悬吊术组差异无统计学意义(P>().05),其上睑迟滞及其他并发症发生率均低于额肌筋膜瓣悬吊术组(P<0.05)。结论 对于肌弹性15 mm以上的重度上睑下垂患者,提上睑肌短缩术效果优于额肌筋膜瓣悬吊术的手术方法,能达到既符合眼睑生理功能,又改善美观的效果。%Objective To prove the feasibility and curative effect of levator muscle resection, and to compare it with other operative methods, to offer both theoretical and clinical evidence to clinical works. Methods According to operation methods, the patients were divided into 2 groups, 24 (29eyes) had gone through levator muscle resection, while the other 8 (9 eyes) had frontal muscle ventrofixation. The patients were observed for 6 months at least, and compared the effect of operation according to palpebra superior location after operation, palpebral fissure hysteresis, palpebra superior dysraphism and exposure keratitis. Results In group that was done shortening operation, after 6 months, the incidence of insufficient rectification and hysteresis of upper eyelid was lower than that of ventrofixation. Meanwhile, success rate of operation after 6 months in former group was similar to that of latter one. Conclusions If elasticity of levator muscle is more than 15mm, levator muscle resection is suitable to severe congenital ptosis; shortening operation shows superiority over the operative method of frontal muscle fascial flap, by recovering physiological function of eyelid and improving the outlook.

  15. 单切口改良额肌筋膜瓣悬吊术治疗重度上睑下垂%Clinical application and effect of simple cut and modified forehead muscle flap suspension operation in treating severe blepharoptosis

    Institute of Scientific and Technical Information of China (English)



    目的 探讨改进传统的额肌瓣悬吊术治疗重度上睑下垂的方法及效果.方法 采用单一重睑线切口制作倒梯形额肌筋膜瓣,并经眶囊隧道悬吊睑板.结果 本组病例共7例10只眼,(单侧4例、双侧3例),术后随访3~18个月,效果满意,无复发.结论 改良单一切口额肌筋膜瓣矫正重度上睑下垂疗效确切,创伤小,值得推广应用.

  16. The treatment of simple shortening of levator palpebrae superioris muscle with authentic power of levator muscle in treating severe congenital blepharoptosis%术中提上睑肌肌张力评估后单纯提上睑肌缩短术的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    王鸿; 王冰; 王利华


    Objective To obtain the treatment of the shortening of levator palpebrae superioris muscle with authentic power of levator muscle in severe congenital ptosis.Methods Measure and estimate the Authentic power of levator muscle of 169 children (216 eyes)with severe congenital ptosis and treat 143 children (182 eyes) of themwith simple Shortening of levator palpebrae superioris muscle.Results The postoperative lid fissure on straight gaze in 216 eyes were over 6mm (6 ~ 9mm) and the position of the superior eyelid margin were over pupil area.The eyelid radian and an upper lid fold were good.Conclusions Children measured no power of levator muscle in severe congenital ptosis could be operated with simple Shortening of levator palpebrae superioris muscle.This procedure could be effective, less-injured and keep the most physiologic construction.%目的 探讨根据术中对提上睑肌肌张力评估采取的单纯提上睑肌缩短术对儿童重症先天性上睑下垂的疗效方法 对169例(216只眼)重症先天性上睑下垂患儿,根据术中实际提上睑肌肌张力的评估,设计手术方式及手术量,其中143例(182只眼)行单纯提上睑肌缩短术,结果 169例(216只眼)术后6个月至2年随访,上睑缘位置均在瞳孔以上,平视时睑裂6~9mm,上睑缘弧度及双重睑形成良好.结论 根据术中对患儿实际提上睑肌肌张力的评估,可选择最佳手术方式及手术量,对术前检查提上睑肌无肌力的患儿实行单纯提上睑肌缩短术,可减少手术创伤,有效改善病变,保留最佳生理解剖结构.

  17. 应用眶隔筋膜瓣联合额肌瓣悬吊矫正重度上睑下垂的临床分析%Clinical analysis of correction of severe blepharoptosis with the orbital musculo-fascial flap and frontalis muscle flap suspension

    Institute of Scientific and Technical Information of China (English)

    孙玉峰; 张芳; 王俊河; 石英光


    目的 探讨眶隔筋膜瓣联合额肌瓣悬吊术在治疗重度上睑下垂中的临床疗效及优势.方法 将2010年9月至2014年9月收治的22例(42只眼)重度上睑下垂患者随机分为两组(每组11例),分别采用改良单切口额肌筋膜瓣悬吊术和眶隔筋膜瓣联合额肌瓣悬吊术治疗,并比较其临床疗效.结果 术后随访1周,1、3、6个月,22例患者(42只眼)4周内上睑均能完全闭合,重睑外形良好,未发生暴露性角膜炎.改良单切口额肌筋膜瓣组中,1例患者术后欠矫,1例出现上睑内翻,5例上睑迟滞;眶隔筋膜瓣联合额肌瓣悬吊组中,1例术后复发.两组患者中,改良单切口额肌筋膜瓣悬吊术矫正程度略高(P<0.05);术后6个月,观察两组疗效差异无统计学意义(P>0.05);术后1个月,眶隔筋膜瓣联合额肌瓣悬吊组较单切口额肌筋膜瓣悬吊组术后上睑回缩量明显减少;术后6个月,两组上睑回缩量差异有显著的统计学意义(P<0.01).结论 两种手术方法均是治疗重度上睑下垂的有效方法,手术安全性高,满意度高.但相对来说,眶隔筋膜瓣联合额肌瓣悬吊术具有并发症少,远期效果较稳定,手术创伤小的优点,值得临床推广应用.

  18. Periorbital scleroderma associated with heterochromia iridis. (United States)

    Stone, R A; Scheie, H G


    Two patients had biopsy-proven linear scleroderma, associated with a pigmentary abnormality of the anterior segment of the eye. One patient had heterochromia iridis, atrophy of the upper eyelid, a typical coup de sabre lesion, and a markedly asymmetric pigmentary glaucoma. The second patient had bilateral scalp involvement, paresis of the extraocular muscles, blepharoptosis, and heterochromia iridis.

  19. Predictive images of postoperative levator resection outcome using image processing software

    Directory of Open Access Journals (Sweden)

    Mawatari Y


    Full Text Available Yuki Mawatari,1 Mikiko Fukushima2 1Igo Ophthalmic Clinic, Kagoshima, 2Department of Ophthalmology, Faculty of Life Science, Kumamoto University, Chuo-ku, Kumamoto, Japan Purpose: This study aims to evaluate the efficacy of processed images to predict postoperative appearance following levator resection.Methods: Analysis involved 109 eyes from 65 patients with blepharoptosis who underwent advancement of levator aponeurosis and Müller’s muscle complex (levator resection. Predictive images were prepared from preoperative photographs using the image processing software (Adobe Photoshop®. Images of selected eyes were digitally enlarged in an appropriate manner and shown to patients prior to surgery.Results: Approximately 1 month postoperatively, we surveyed our patients using questionnaires. Fifty-six patients (89.2% were satisfied with their postoperative appearances, and 55 patients (84.8% positively responded to the usefulness of processed images to predict postoperative appearance.Conclusion: Showing processed images that predict postoperative appearance to patients prior to blepharoptosis surgery can be useful for those patients concerned with their postoperative appearance. This approach may serve as a useful tool to simulate blepharoptosis surgery. Keywords: levator resection, blepharoptosis, image processing, Adobe Photoshop® 

  20. Ptosis - infants and children (United States)

    Blepharoptosis-children; Congenital ptosis; Eyelid drooping-children; Eyelid drooping-amblyopia; Eyelid drooping-astigmatism ... Ptosis in infants and children is often due to a problem with the muscle that raises the eyelid. A nerve problem in the eyelid can ...

  1. Surgical reconstruction of complications associated with fronto-ethmoid mucocele surgery. (United States)

    Guibor, P


    Devastating complications can occur following an uncomplicated resection of a fronto-ethmoid mucocele, namely, total blepharoptosis, diplopia, and vertical-horizontal extraocular muscle abnormalities. Four stages of reconstructive surgery were required over a two-year period of time to arrive at an acceptable appearance and useful binocular vision. Maximum care must be exercised when resecting a fronto-ethmoid mucocele. Inadvertent trauma to the orbital anatomy may result in a multitude of serious ocular complications.

  2. Glaucoma in Fuchs' heterochromic cyclitis associated with congenital Horner's syndrome.


    Regenbogen, L S; Naveh-Floman, N


    We report a retrospective study of five patients with monocular Fuchs' heterochromic cyclitis associated with an ipsilateral Horner's syndrome. The minimum follow-up was 10 years. The presenting findings were cyclitis in three of the patients and heterochromia iridis associated with blepharoptosis in the other two. The major factors affecting all five patients were cataract and glaucoma. The intraocular pressure was uncontrolled even with maximal therapy, and antiglaucomatous surgery was perf...

  3. Michels syndrome: The first case report from India and review of literature

    Directory of Open Access Journals (Sweden)

    Adedayo A Adio


    Full Text Available A 2-year 7-month-old girl born out of a consanguineous marriage, presented at our facility with clinical features characterized by the eyelid triad of blepharophimosis, blepharoptosis and epicanthus inversus in association with hypertelorism, cleft palate and craniosynostosis. This constellation of features is suggestive of Michels syndrome. At the time of writing this report, there were only ten reported cases worldwide and to the best of our knowledge, there have been no published reports from India.

  4. Horner’s Syndrome Incidental to Medullary Thyroid Carcinoma Excision: Case Report and Brief Literature Review



    Horner’s syndrome is characterized by a combination of ipsilateral miosis, blepharoptosis, enophthalmos, facial anhidrosis, and iris heterochromia in existence of congenital lesions. The syndrome results from a disruption of the ipsilateral sympathetic innervation of the eye and ocular adnexa at different levels. Though rare, thyroid and neck surgery could be considered as possible causes of this clinical entity. We present a case of Horner’s syndrome in a patient after total thyroidectomy an...

  5. Avaliação dos resultados cirúrgicos com a técnica da ressecção do músculo de Müller-conjuntiva no tratamento da blefaroptose Evaluation of the surgery results of Müller's muscle-conjunctival resection in the treatment of ptosis

    Directory of Open Access Journals (Sweden)

    Serge Morax


    Full Text Available OBJETIVO: Avaliar os resultados obtidos com a ressecção do músculo de Müller-conjuntiva no tratamento da blefaroptose e analisar suas vantagens. MÉTODOS: Trinta e oito pacientes (39 pálpebras foram submetidos à ressecção do músculo de Müller-conjuntiva. Blefaroptose no pré-operatório variou de 1,0 mm a 3,0 mm (média: 2,0 mm. O valor de elevação palpebral produzido pelo teste da fenilefrina indicou a quantidade de tecido a ser ressecado. RESULTADOS: 33 pálpebras (85% que foram tratadas com este procedimento tiveram resultado estético satisfatório. CONCLUSÃO: Ressecção do músculo de Müller-conjuntiva é técnica relativamente simples para o tratamento da blefaroptose, quando houver boa função do músculo levantador da pálpebra superior e teste da fenilefrina 10% positivo. Suas vantagens são a preservação do tarso e o resultado cirúrgico previsível.OBJETIVE: To evaluate the results of Müller's muscle-conjunctival resection for correction of blepharoptosis and to discuss the advantages of this procedure. METHODS: 38 patients (39 eyelids were submitted to Müller's muscle-conjunctival resection. Blepharoptosis varied from 1.0 mm to 3.0 mm (mean: 2.0 mm. The amount of eyelid elevation produced by phenylephrine guided the amount of tissue to be resected. RESULT: 33 eyelids (85% treated with this procedure were cosmetically acceptable. CONCLUSIONS: Müller's muscle-conjunctival resection procedure is a relatively simple technique for blepharoptosis, with good levator function and positive 10% phenylephrine test. The advantages are: preservation of tarsus and predictable results.

  6. Electrical stimulation to the trigeminal proprioceptive fibres that innervate the mechanoreceptors in Müller's muscle induces involuntary reflex contraction of the frontalis muscles. (United States)

    Matsuo, Kiyoshi; Osada, Yoshiro; Ban, Ryokuya


    The levator and frontalis muscles lack interior muscle spindles, despite consisting of slow-twitch fibres that involuntarily sustain eyelid-opening and eyebrow-raising against gravity. To compensate for this anatomical defect, this study hypothetically proposes that initial voluntary contraction of the levator fast-twitch muscle fibres stretches the mechanoreceptors in Müller's muscle and evokes proprioception, which continuously induces reflex contraction of slow-twitch fibres of the levator and frontalis muscles. This study sought to determine whether unilateral transcutaneous electrical stimulation to the trigeminal proprioceptive fibres that innervate the mechanoreceptors in Müller's muscle could induce electromyographic responses in the frontalis muscles, with monitoring responses in the orbicularis oculi muscles. The study population included 27 normal subjects and 23 subjects with aponeurotic blepharoptosis, who displayed persistently raised eyebrows on primary gaze and light eyelid closure. The stimulation induced a short-latency response in the ipsilateral frontalis muscle of all subjects and long-latency responses in the bilateral frontalis muscles of normal subjects. However, it did not induce long-latency responses in the bilateral frontalis muscles of subjects with aponeurotic blepharoptosis. The orbicularis oculi muscles showed R1 and/or R2 responses. The stimulation might reach not only the proprioceptive fibres, but also other sensory fibres related to the blink or corneal reflex. The experimental system can provoke a monosynaptic short-latency response in the ipsilateral frontalis muscle, probably through the mesencephalic trigeminal proprioceptive neuron and the frontalis motor neuron, and polysynaptic long-latency responses in the bilateral frontalis muscles through an unknown pathway. The latter neural circuit appeared to be engaged by the circumstances of aponeurotic blepharoptosis.

  7. [Surgical treatment of the Marcus-Gunn syndrome. Indications and results. Apropos of 15 cases]. (United States)

    Morax, S; Mimoun, G


    Fifteen cases of jaw-winking blepharoptosis treated, are reported, to suggest the management of the surgical methods. The degree of the ptosis, the eyelid retraction, the surgical procedures are reviewed. Patients with a wild retraction required a levator muscle resection. Patients with a moderate or severe retraction required an unilateral levator denervation with frontalis suspension. In this case, the most satisfactory surgical results were obtained with unilateral levator denervation on the affected side compared with a bilateral frontalis suspension with fresh autogenous fascia. Then, the surgical procedure seems to depend especially on the eyelid retraction.

  8. Horner’s Syndrome Incidental to Medullary Thyroid Carcinoma Excision: Case Report and Brief Literature Review

    Directory of Open Access Journals (Sweden)

    Nicholas S. Mastronikolis


    Full Text Available Horner’s syndrome is characterized by a combination of ipsilateral miosis, blepharoptosis, enophthalmos, facial anhidrosis, and iris heterochromia in existence of congenital lesions. The syndrome results from a disruption of the ipsilateral sympathetic innervation of the eye and ocular adnexa at different levels. Though rare, thyroid and neck surgery could be considered as possible causes of this clinical entity. We present a case of Horner’s syndrome in a patient after total thyroidectomy and neck dissection for medullary thyroid cancer with neck nodal disease and attempt a brief review of the relevant literature.

  9. Horner's Syndrome Incidental to Medullary Thyroid Carcinoma Excision: Case Report and Brief Literature Review (United States)

    Mastronikolis, Nicholas S.; Spiliopoulou, Sofia P.; Zolota, Vassiliki; Papadas, Theodoros A.


    Horner's syndrome is characterized by a combination of ipsilateral miosis, blepharoptosis, enophthalmos, facial anhidrosis, and iris heterochromia in existence of congenital lesions. The syndrome results from a disruption of the ipsilateral sympathetic innervation of the eye and ocular adnexa at different levels. Though rare, thyroid and neck surgery could be considered as possible causes of this clinical entity. We present a case of Horner's syndrome in a patient after total thyroidectomy and neck dissection for medullary thyroid cancer with neck nodal disease and attempt a brief review of the relevant literature. PMID:27200201

  10. Glaucoma in Fuchs' heterochromic cyclitis associated with congenital Horner's syndrome. (United States)

    Regenbogen, L S; Naveh-Floman, N


    We report a retrospective study of five patients with monocular Fuchs' heterochromic cyclitis associated with an ipsilateral Horner's syndrome. The minimum follow-up was 10 years. The presenting findings were cyclitis in three of the patients and heterochromia iridis associated with blepharoptosis in the other two. The major factors affecting all five patients were cataract and glaucoma. The intraocular pressure was uncontrolled even with maximal therapy, and antiglaucomatous surgery was performed in all cases. A short period of good postoperative control was followed by an intractable ocular hypertension, causing loss of useful vision in all patients. The remarkable combination of Horner's syndrome with glaucoma and their interaction is discussed.

  11. Horner's Syndrome Incidental to Medullary Thyroid Carcinoma Excision: Case Report and Brief Literature Review. (United States)

    Mastronikolis, Nicholas S; Spiliopoulou, Sofia P; Zolota, Vassiliki; Papadas, Theodoros A


    Horner's syndrome is characterized by a combination of ipsilateral miosis, blepharoptosis, enophthalmos, facial anhidrosis, and iris heterochromia in existence of congenital lesions. The syndrome results from a disruption of the ipsilateral sympathetic innervation of the eye and ocular adnexa at different levels. Though rare, thyroid and neck surgery could be considered as possible causes of this clinical entity. We present a case of Horner's syndrome in a patient after total thyroidectomy and neck dissection for medullary thyroid cancer with neck nodal disease and attempt a brief review of the relevant literature.

  12. Regeneração aberrante do nervo oculomotor secundária a aneurisma intracraniano: relato de caso Aberrant regeneration of the oculomotor nerve followed by intracranial aneurysm: case report

    Directory of Open Access Journals (Sweden)

    Renato Wendell Ferreira Damasceno


    Full Text Available Relatar um caso de regeneração aberrante secundária à paralisia aguda do nervo oculomotor causada por aneurisma intracraniano. Paciente atendida em fevereiro de 2006 queixando-se de dor de cabeça acompanhada de visão dupla e queda da pálpebra no olho direito. Na avaliação da motilidade ocular extrínseca, verificou-se incapacidade da adução, da supradução e da infradução associada à blefaroptose no olho direito. Com relação à motilidade intrínseca, midríase paralítica no olho direito. Formulou-se diagnóstico de paralisia aguda de nervo oculomotor no olho direito e solicitou-se avaliação neurológica. No Departamento de Neurocirurgia, após ser diagnosticada presença de aneurisma de artéria comunicante posterior, a paciente foi submetida a tratamento cirúrgico. Em dezembro de 2006, observou-se melhora relativa da adução, mantendo a incapacidade da supradução e da infradução com blefaroptose melhorada à adução do olho direito. Com relação à motilidade intrínseca, miose no olho afetado. O diagnóstico de regeneração aberrante do nervo oculomotor pós-paralisia aguda foi formulado baseando-se na anamnese e nos exames oftalmológicos seqüenciais.To report a case of aberrant regeneration followed by acute palsy of the oculomotor nerve caused by intracranial aneurysm. A 59-year-old patient was attended in February 2006 complaining of headache with diplopia and blepharoptosis in the right eye. At the external ocular motility exam. Aduction, supraduction and infraduction defects with blepharoptosis in the right eye were observed. Regarding the internal ocular motility, mydriasis in the right eye. Acute palsy of the oculomotor nerve in the right eye was diagnosed and neurological examination was requested. At the Department of Neurosurgery, after having diagnosed aneurysm of the posterior communicating artery, the patient was submitted to an operation. In December 2006, it improvement of the aduction was

  13. [Progressive external ophthalmoplegia and distal myopathy]. (United States)

    Damian, C


    A patient, 58 years old, presents progressive blepharoptosis, in both eyes and external ophthalmoplegia. The general somatic examination, shows, at the level of the higher limbs, distal myopathy with muscular hypotony and articular deformities fibrosis and tendinous retraction. On examining the eye bottom we found colloid degeneration in the muscle region. Within the same family a ten-year-old nephew presents congenital ptosis. The muscular biopsy from the levator palpebrae shows muscular degenerative lesions with the reduction of nuclei and the proliferation of conjunctive tissue. It is shown that progressive external ophthalmoplegia must be interpreted as an ocular myopathy. The association with the distal myopathy at the level of the higher limbs, in the presented observation, upholds this pathogeny.

  14. Lenz microphthalmia syndrome: three additional cases with rare associated anomalies. (United States)

    Temtamy, S A; Ismail, S I; Meguid, N A


    Lenz microphthalmia syndrome is an extremely rare inherited disorder, characterized by unilateral or bilateral microphthalmia. In rare cases affected patients exhibit complete absence of eye or blepharoptosis resulting in visual impairment. Additional physical abnormalities are often associated with this disorder, orofacial, digital, skeletal and urogenital abnormalities. Here we present three cases of Lenz microphthalmia with additional manifestations: two brothers of first cousin mating, the elder one has bilateral congenital cataract which is a rare ophthalmological finding in this syndrome and a third case who presented to us because of ambiguous genitalia. She was 12 years old, and reared as a female. Chromosomal analysis showed 46,XY karyotype, and hormonal studies indicated 5-alpha reductase deficiency. This is the first report of the association of 5-alpha reductase deficiency with Lenz microphthalmia syndrome.

  15. Hemifacial hyperhidrosis associated with ipsilateral/contralateral cervical disc herniation myelopathy. Functional considerations on how compression pattern determines the laterality. (United States)

    Iwase, Satoshi; Inukai, Yoko; Nishimura, Naoki; Sato, Maki; Sugenoya, Junichi


    Sweating is an important mechanism for ensuring constant thermoregulation, but hyperhidrosis may be disturbing. We present five cases of hemifacial hyperhidrosis as a compensatory response to an/hypohidrosis caused by cervical disc herniation. All the patients complained of hemifacial hyperhidrosis, without anisocoria or blepharoptosis. Sweat function testing and thermography confirmed hyperhidrosis of hemifacial and adjacent areas. Neck MRI showed cervical disc herniation. Three of the patients had lateral compression with welldemarcated hypohidrosis below the hyperhidrosis on the same side as the cervical lesion. The rest had paramedian compression with poorly demarcated hyperhidrosis and hypohidrosis on the contralateral side. Although MRI showed no intraspinal pathological signal intensity, lateral dural compression might influence the circulation to the sudomotor pathway, and paramedian compression might influence the ipsilateral sulcal artery, which perfuses the sympathetic descending pathway and the intermediolateral nucleus. Sweat function testing and thermography should be performed to determine the focus of the hemifacial hyperhidrosis, and the myelopathy should be investigated on both sides.

  16. An Overview of Ophthalmologic Survey Methodology in the 2008-2015 Korean National Health and Nutrition Examination Surveys. (United States)

    Yoon, Kyung Chul; Choi, Won; Lee, Hyo Seok; Kim, Sang-Duck; Kim, Seung-Hyun; Kim, Chan Yun; Park, Ki Ho; Park, Young Jeung; Baek, Seung-Hee; Song, Su Jeong; Shin, Jae Pil; Yang, Suk-Woo; Yu, Seung-Young; Lee, Jong Soo; Lim, Key Hwan; Oh, Kyung Won; Kang, Se Woong


    The Korea National Health and Nutrition Examination Survey (KNHANES) is a national program designed to assess the health and nutritional status of the noninstitutionalized population of South Korea. The KNHANES was initiated in 1998 and has been conducted annually since 2007. Starting in the latter half of 2008, ophthalmologic examinations were included in the survey in order to investigate the prevalence and risk factors of common eye diseases such as visual impairment, refractive errors, strabismus, blepharoptosis, cataract, pterygium, diabetic retinopathy, age-related macular degeneration, glaucoma, dry eye disease, and color vision deficiency. The measurements included in the ophthalmic questionnaire and examination methods were modified in the KNHANES IV, V, and VI. In this article, we provide detailed information about the methodology of the ophthalmic examinations in KNHANES in order to aid in further investigations related to major eye diseases in South Korea.

  17. Horner's syndrome and contralateral abducens nerve palsy associated with zoster meningitis. (United States)

    Cho, Bum-Joo; Kim, Ji-Soo; Hwang, Jeong-Min


    A 55-year-old woman presented with diplopia following painful skin eruptions on the right upper extremity. On presentation, she was found to have 35 prism diopters of esotropia and an abduction limitation in the left eye. Two weeks later, she developed blepharoptosis and anisocoria with a smaller pupil in the right eye, which increased in the darkness. Cerebrospinal fluid analysis showed pleocytosis and a positive result for immunoglobulin G antibody to varicella zoster virus. She was diagnosed to have zoster meningitis with Horner's syndrome and contralateral abducens nerve palsy. After intravenous antiviral and steroid treatments, the vesicular eruptions and abducens nerve palsy improved. Horner's syndrome and diplopia resolved after six months. Here we present the first report of Horner's syndrome and contralateral abducens nerve palsy associated with zoster meningitis.

  18. 先天性上睑下垂患者提上睑肌解剖结构的研究

    Institute of Scientific and Technical Information of China (English)

    张旭霞; 邓玲; 陈蕾; 冯亮; 谭雪红


    AIM:To explore the levator palpebrae superioris anatomy abnormal manesfaction in congetinal blepharoptosis patients.METHODS:We performed monocular congenital blepharoptosis with another eye was normal and no double eyelid crease in 30 patients . The normal eyes were been as contrasted. Separated and exposured the levator aponeurosis to check ligament ,observed poneurosis and check ligament anatomy structure.We measured the width of check ligament and the distance from check ligament to the upper border of tarsus in 30 congenital blepharoptosis eyes and 30 normal eyes, three times in all and averaged..RESULTS: There are check ligament abnormal attach 12 eyes , thickness increased 8 eyes, width increased 6 eyes, the distance from check ligament to upper border of tarsus lower 3 eyes. aponeurosis thinner 6 eyes, aponeurosis fatty 5 eyes, aponeurosis pore 4 eyes in 30 congenital blepharoptosis eyes. The distance from check ligament to upper border of tarsus15.145±5.45 mm, the check ligament width5.51 ±1.89 mm. In 30 normal eyes the distance from check ligament to upper border of tarsus17.624±2.38 mm, the check ligament width3.765 ± 3.24mm..There are no significant difference of the distance from check ligament to upper border of tarsus and the check ligament width between congenital blepharoptosis eyes and normal eyes..CONCLUSION: There are anatomy abnormal of the levator palpebrae superiors in congenital blepharoptosis patient, it is not the important factor of etiology. There are another etiology mechanism to explore.%目的探讨先天性上睑下垂患者提上睑肌的解剖结构异常的表现形式.方法选单眼先天性上睑下垂患者健眼为单睑者30例,患眼30眼施上睑下垂矫正术,30眼行重睑成形术.以健眼作为对照,术中观察患眼及健眼节制韧带及腱膜解剖结构特点,用游标卡尺分别测量患眼及健眼节制韧带宽度及节制韧带至睑板上缘距离,测量3次,取平均值.结果先天性上睑下垂30

  19. Diminuição da função do músculo levantador da pálpebra superior em pacientes submetidos à cirurgia de ptose palpebral involucional e dermatocálase Decrease of upper eyelid levator muscle function after involutional ptosis and dermatochalasis surgery

    Directory of Open Access Journals (Sweden)

    Eliana Forno


    Full Text Available OBJETIVO: Avaliar a diferença da função do músculo levantador da pálpebra superior (FMLPS, distância margem reflexo (DMR1 e altura do sulco palpebral (AS antes e depois da cirurgia de blefaroplastia superior associada à correção de ptose palpebral. MÉTODOS: Quarenta e quatro pacientes com blefaroptose e dermatocálase foram incluídos. Intervenção: exploração do tendão do músculo levantador da pálpebra superior (MLPS durante a blefaroplastia, em portadores de blefaroptose e dermatocálase. Nos casos de desinserção, o tendão foi refixado ao tarso. Desfechos analisados: foram analisados de forma bilateral a diferença entre FMLPS, DMR1 e AS antes e depois da intervenção. A dependência entre os olhos foi corrigida por meio de equações de estimativa generalizada. Foi utilizada a correlação de Pearson para quantificar a dependência entre os olhos para FMLPS, DMR1 e AS. RESULTADOS: Houve diferença significante entre as medidas de FMLPS antes e depois da cirurgia, havendo redução da excursão do MLPS após a cirurgia, diminuindo, em média, 1,1 mm (P0,01. CONCLUSÃO: A função do músculo levantador da pálpebra superior diminui após a cirurgia para a correção da ptose.PURPOSE: To evaluate the differences between upper eyelid levator muscle function (UELMF, margin reflex distance (MDR1, and eyelid crease height (ECH before and after ptosis and dermatochalasis surgery. METHODS: Forty-four patients with blepharoptosis and dermatochalasis were enrolled. Intervention: An exploration of the levator tendon (LT during a blepharoplasty procedure in patients with blepharoptosis and dermatochalasis and in case of its disinsertion, the tendon was reattached to the tarsus. Measured outcome: The differences between UELMF, MDR1, ECH before and after surgery were evaluated bilaterally. Dependency between both eyes was corrected by generalized estimating equations. Pearson correlation was used to evaluate the dependency of the two

  20. Further evidence for the role of the caudate nucleus in programming motor and nonmotor behavior in Java monkeys. (United States)

    Vrijmoed-de Vries, M C; Cools, A R


    This study describes the short-term effects of intracaudate microinjections of carbachol in temporarily isolated and restrained Java monkeys. The monkeys were found to display a series of motor disturbances including blepharoptosis, facial twitches, tongue protrusions, ear flattening, torticollis, and compulsive alternations of rapid flexions and extensions of the extremities. In general, carbachol was found to produce consistent effects as far as it concerns its ability to elicit motor disturbances. Three of the five tested monkeys had previously received another series of carbachol injections when they were freely moving and living in a stabilized social group. Accordingly, the present study enabled us to compare the effectiveness of threshold doses of carbachol in the same monkey in two distinct situations. We concluded first, that motor disturbances and disturbances in social communication were closely coupled in relation to the involvement of a particular cholinoceptive substrate within the caudate nucleus of Java monkeys. Second, the motor disturbances under study appeared to require a larger degree of dysfunctioning of this substrate than did subtle disturbances in the social communication of these monkeys. And, finally, stress inherent to restraint increased the susceptibility of the cholinoceptive substrate within the caudate nucleus. The clinical impact of our findings is discussed in view of differences between the premorbid and manifest phases of Parkinson's disease.

  1. [Case of unilateral thalamo-mesencephalic infarction with enlargement to bilateral vertical gaze palsy due to vertical one-and-a-half syndrome]. (United States)

    Suzuki, Keisuke; Odaka, Masaaki; Tatsumoto, Muneto; Miyamoto, Tomoyuki; Takamatsu, Kazuhiro; Hirata, Koichi


    An 88-year-old female with atrial fibrillation and hypertension, was admitted to our hospital with sudden onset diplopia and somnolence. She had right hemiparesis with bilateral positive Babinski's sign. Additionally, there was bilateral blepharoptosis with right esotropia. With regard to extraocular movement, the patient demonstrated conjugate upgaze palsy and left monocular down gaze palsy (vertical one-and-a-half syndrome: VOHS). Horizontal gaze in the left eye was completely impaired and there was limited abduction of the right eye. Magnetic resonance imaging of the brain showed left thalamo-mesencephalic infarction. On day 4, the vertical eye movement developed into conjugate upgaze and down- gaze palsies. Magnetic resonance imaging of the brain indicated high signal lesion extending into the dorsal portion of the midbrain. It was suggested that the pathway to contralateral downgaze neurons could have been damaged due to the unilateral (left) dosal midbrain lesion before its decussation with the unilateral interstitial nucleus of Cajal, the oculomotor nucleus and the rostral interstitial nucleus of the medial longitudinal fasciculus. This case is considered to be important because there has been no previous report of bilateral vertical gaze palsy due to VOHS in the same patient. Since there are various patterns of ocular movement disorder in the thalamo-mesencephalic portion, careful observations are required to localize the lesions.

  2. Antidepressant effect of bioactive compounds from Paecilomyces tenuipes in mice and rats

    Institute of Scientific and Technical Information of China (English)

    Hongwei Kan; Liang Ming; Chunru Li; Hongxing Kan; Bei Sun; Yan Liang


    A bioactive compound from Paecilomyces tenuipes(BCPT)has an inhibitory effect on monoamine oxidase A(MAO-A)in vitro.Researchers have thought that BCPT may be a potential antidepressant.The MAO-A suppressor moclobemide served as a control,and this study investigated the mechanisms of BCPT as an antidepressant.Results demonstrated that BCPT induced significantly increased sucrose intake in chronic unpredictable stressed rats,shortened immobility time in forced swimming mice,improved the scores of blepharoptosis and akinesia in reserpine-treated mice,increased the number of 5-hydroxy tryptophan-induced head-twitches,remarkably enhanced the expression of hippocampus mineralcorticoid receptor and glucocorticoid receptor mRNA,decreased the ratio of mineralcorticoid receptor to glucocorticoid receptor and raised the levels of dopamine,norepinephrine and 5-hydroxytryptamine,while decreasing hydroxyindole acetic acid levels or dihydroxy-phenyl acetic acid in chronic unpredictable stressed rats.Behavioral test results suggested that BCPT potentially had antidepressant-like activity.Meanwhile,BCPT increased the levels of neurotransmitters,and mineralcorticoid receptor and glucocorticoid receptor mRNA in the hippocampus,which may be an important mechanism of its antidepressant effect.

  3. Acquired oculomotor muscle fibrosis in infant: case report

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    Carlos Ramos de Souza-Dias


    Full Text Available The authors report the case of a 5 year-old boy who up to 2 years old presented normal eyes, when his right eye started to deviate upward and laterally, until be hidden under the superior lid. At the surgery, a strong passive limitation to infraduction of this eye was felt. He had already been operated on in another clinic, but the surgeon could not succeed in hooking his superior rectus. With great difficulty, the only thing that we could do was a free tenotomy of the superior rectus. As the eye was equilibrated in a moderate abduction, we performed an 8 mm recession of the lateral rectus. As there was still a small hypertropia and exotropia postoperatively, we performed in a second operation an eight millimeters resection of the medial rectus, a recession with anterior transposition of the inferior oblique and an advancement of the inferior rectus according to the Romero-Apis technique, in order to avert circulatory problems to the anterior segment of the eye. As he presented a small blepharoptosis, we did, in a third surgery, a tarsectomy according to the Fasanella-Servat technique, with good result. He ended with good eye position, almost no limitation of the horizontal movements and - 3 limitation of up and down ductions. The magnetic resonance imaging showed an altered image of the superior rectus, suggesting fibrosis post myositis.

  4. Familial blepharophimosis syndrome: study of two colombian families and two sporadic cases Síndrome de la blefarotimosis familiar: estudio de dos familias colombianas y dos casos esporádicos

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    José Luis Ramírez Castro


    Full Text Available

    The blepharophimosis syndrome includes several associated anomalies, namely: blepharophimosis, blepharoptosis, epicanthus inversus and telecanthus. It is inherited as an autosomal dominant defect with essentially 100% penetrance. To the nearly 180 previously reported cases our report adds another 25 occurring in two colombian families through 3 and 4 generations (23 cases and in 2 sporadic cases. Some related clinical, embryological and genetic aspects of this syndrome are discussed.

    El síndrome denominado blefarofimosis familiar comprende varias anomalías asociadas entre las cuales se destacan: blefarofimosis, blefaroptosis, epicanto Inverso y telecanto. Se hereda en forma autosómica dominante con una penetrancia completa. Se han Informado en la literatura aproximadamente 180 casos, a los cuales se adicionan 23 detectados en las 2 familias colombianas que estamos reponando a través de 3 y 4 generaciones (familias A y B respectivamente y dos esporádicos. Se discuten aspectos clínicos, embriológicos y gen éticos relacionados con el síndrome.

  5. Selected case from the Arkadi M. Rywlin International Pathology Slide Series: Mitochondrial myopathy presenting with chronic progressive external ophthalmoplegia (CPEO): a case report. (United States)

    Bisceglia, Michele; Crociani, Paola; Fogli, Danilo; Centola, Antonio; Galliani, Carlos A; Pasquinelli, Gianandrea


    A 43-year-old female patient diagnosed with chronic progressive external ophthalmoplegia (CPEO) because of mitochondrial myopathy documented by muscle biopsy is presented. The chief complaints were represented by blepharoptosis and ophthalmoplegia. The muscle biopsy was evaluated by histology, using the appropriate histochemical and histoenzimological stains. Ragged red fibers with Gomori trichrome stain were seen, which showed cytochrome c oxydase deficiency and abnormal succinate dehydrogenase staining in around 20% of muscle fibres. Electron microscopy was also performed which demonstrated abnormal, hyperplastic, pleomorphic, and hypertrophic mitochondria, characterized by paracrystalline inclusions arranged in parallel rows ("parking-lot" inclusions), consisting of rectangular arrays of mitochondrial membranes in a linear or grid-like pattern. In conclusion, mitochondrial myopathy was definitely diagnosed. Although molecular analysis, which was subsequently carried out, failed to reveal mutations in the mitochondrial DNA or in selected nuclear genes, the pathologic diagnosis was not changed. The differential diagnosis of CPEO with other forms of ocular myopathies as well as the possible association of CPEO with systemic syndromes is discussed. Ophtalmologists and medical internists should always suspect CPEO when dealing with patients affected by ocular myopathy, either in its pure form or in association with other myopathic or systemic signs.

  6. Horner Syndrome Secondary to Thyroid Surgery (United States)

    Binay, Ciğdem; Simsek, Enver; Ilhan, Hüseyin


    Horner syndrome (HS), caused by an interruption in the oculosympathetic pathway, is characterised by myosis, ipsilateral blepharoptosis, enophthalmos, facial anhydrosis, and vascular dilation of the lateral part of the face. HS is a rare complication of thyroidectomy. A 15-year-old female patient presented with solitary solid and large nodule in the right thyroid lobe. Ultrasound-guided fine-needle aspiration was performed and the cytological examination results were undefined. The patient underwent a total thyroidectomy. On postoperative day 2, she developed right-sided myosis and upper eyelid ptosis. HS was diagnosed. Interestingly, the patient exhibited an incomplete clinical syndrome with the absence of vasomotor symptoms. We herein report a case of HS in a 15-year-old female patient after total thyroidectomy. The possible causes of HS were ischaemia-induced nerve damage and stretching of the cervical sympathetic chain by the retractor during thyroidectomy. Clinicians should be aware of the possibility of this rare but important surgical complication. PMID:28133554

  7. Temporal Artery Calciphylaxis Presenting as Temporal Arteritis in a Case of Rhinoorbitocerebral Mucormycosis. (United States)

    Chi, Mijung; Kim, H Jane; Basham, Ryan; Yoon, Michael K; Vagefi, Reza; Kersten, Robert C


    Mucormycosis is a rare often fatal opportunistic fungal infection. It is typically described in patients with diabetes in ketoacidotic status and is rare in renal transplant recipients. Calciphylaxis is a rare and highly morbid disease of vascular calcification affecting patients with end-stage renal disease (ESRD). The first case of a renal transplant recipient who was inflicted with both rhinoorbitocerebral mucormycosis and calciphylaxis is reported. A 45-year-old man presented with 2-day history of left upper blepharoptosis, periorbital pain, left-sided headache, binocular diplopia, and left V2 numbness. He had undergone renal transplant for ESRD 7 months earlier with resultant immunosuppressive therapy. MRI and nasal biopsy confirmed rhinoorbitocerebral mucormycosis. Immunosuppressive therapy was stopped and antifungal therapy begun. He had orbital exenteration for progressive rhinoorbitocerebral mucormycosis. Two months later, the patient reported new-onset intermittent bitemporal headache and bilateral swollen, tender temporal arteries. Temporal artery biopsy revealed features consistent with calciphylaxis. Clinical presentation, treatment course, and follow up are discussed.

  8. 开郁胶囊对抑郁动物模型的影响%Effects of Kaiyu Capsule on Depression-like Animal Models

    Institute of Scientific and Technical Information of China (English)

    李雅莉; 赵玲; 魏海峰; 李林


    head-twitching number induced by 5-HTP( P < 0. 01 ), and shortened the latency period ( P < 0. 05 ). After sc reserpine, the mice appeared physical signs such as blepharoptosis, akinesia and hypothermia. The middle and high doses of Kaiyu capsule significantly ameliorated the blepharoptosis and akinesia( P < 0. 01 ), and decreased the range of hypothermia in reserpine-induced model mice( P <0. 01 ). Conclusion: Kaiyu capsule has the significant antidepressant effect, and the mechanisms may be related to the enhancement of serotonergie and noradrenergic functions.

  9. 产瘫患儿Horner征的临床观察%Clinical observation of concurrent Horner's sign in infants with obstetric brachial plexus palsy

    Institute of Scientific and Technical Information of China (English)

    李清; 陈亮; 胡韶楠


    Objective To discuss the diagnostic value of concurrent Horner's sign in infants with obstetric brachial plexus palsy and discover the clinical characteristics of Horner's syndrome caused by C7 nerve root avulsion alone.Methods From January 2009 to July 2009,39 infants with OBPP were identified with concurrent Horner' s syndrome.Clinical signs of Homer's syndrome were recorded which include ipsilateral blepharoptosis,pupillary miosis and facial anhidrosis.Lesions of brachial plexus nerve roots were confirmed during the surgery by direct visualization and electrophysiology.After a period of 6-month follow-up,these signs were recorded again.Results The initial age of Horner's sign evaluation of these OBPP patients was(3.58 ±0.87)months.Average postoperative follow-up interval was(6.19 ± 1.10)months.C7 nerve root avulsion alone was confirmed in 11 patients(case group),while the other 28 patients(control group)lind avulsion of at least one root of C8 and T1 nerve roots.There were not significant differences in anisocoria and blepharoptosis between the two groups(P > 0.05).Facial gland secretary function was recovered more rapidly among patients in case group than their counterparts(P < 0.05).Conclusion In newborns with OBPP,Horner' s syndrome can be correlated with C7 nerve root avulsion alone.No unique feature of Horner's syndrome which caused by C7 nerve root avulsion was found among patients of 3 months old.%目的 探讨Horner征在产瘫中的诊断意义,寻找单纯C7神经根撕脱导致Horner征的特异性临床体征.方法 对2009年1月至7月在我院接受手术治疗的39例Horner征阳性的产瘫患儿,术前记录患侧Horner征3项临床体征:瞳孔大小,睑裂大小及面部汗腺分泌功能.术中通过直视观察联合神经电生理检查明确患儿神经根损伤程度,并在患儿术后首次随访时再次记录Horner征的各项体征.结果 产瘫患儿平均首次评估Horner征时间为(3.58±0.87)个月.

  10. Uso da fáscia temporal na suspensão frontal: descrição da técnica cirúrgica - Relato de caso Use of temporal fascia in frontalis suspension: description of the surgical technique - Case report

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    Tânia Pereira Nunes


    Full Text Available OBJETIVOS: Familiarizar o oftalmologista com a anatomia da região temporal, descrever a técnica cirúrgica da retirada da fáscia temporal e da suspensão frontal e analisar as vantagens e desvantagens da fáscia temporal na suspensão frontal. MÉTODOS: Revisão do prontuário de uma paciente com blefaroptose grave que foi submetida à suspensão frontal com fáscia temporal. Revisão da anatomia da fossa temporal e das técnicas cirúrgicas. RESULTADOS: Bom resultado estético e funcional foi conseguido no caso descrito. CONCLUSÃO: A fáscia temporal é boa opção na suspensão frontal com algumas vantagens: é um tecido autógeno, de fácil obtenção e mínima morbidade no pós-operatório.PURPOSE: To familiarize the ophthalmologist with the anatomy of the temporal region, to describe the surgical technique of temporal fascia harvest and frontalis suspension and to demonstrate advantages and disadvantages of temporal fascia in frontalis suspension. METHODS: Review of the clinical and surgical data of one case with severe blepharoptosis who underwent frontalis suspension using temporal fascia. Review of the anatomy of the temporal fossa and the surgical techniques. RESULTS: Good esthetic and functional results were obtained in this case. CONCLUSION: Temporal fascia is a good choice for frontalis suspension with some advantages: it is autogenous, it is easily harvested and it yields minimal post-operative morbidity.

  11. Refined distribution of myelinated trigeminal proprioceptive nerve fibres in Mueller's muscle as the mechanoreceptors to induce involuntary reflexive contraction of the levator and frontalis muscles. (United States)

    Yuzuriha, Shunsuke; Matsuo, Kiyoshi; Hirasawa, Chihiro; Moriizumi, Tetsuji


    Stretching of mechanoreceptors in Mueller's muscle induces reflexive contraction of not only the levator muscle but also the frontalis muscle as two different eyelid-opening muscles. Previously, we reported that fine neural myelinated structures, acting as mechanoreceptors, were found in the proximal Mueller's muscle. Since there is a risk of misunderstanding that the middle and distal Mueller's muscle does not contain mechanoreceptors and can be invalidated or resected, the accurate distribution of myelinated trigeminal proprioceptive nerve fibres as mechanoreceptors in Mueller's muscle was refined horizontally in this study. We explored 10 whole Mueller's muscles between the levator muscle and the tarsus of the upper eyelids obtained from five Japanese cadavers. The specimens were serially sliced along the horizontal plane and stained with HE, S-100 protein to determine the presence of Schwann cells, and smooth muscle actin antibody to determine the presence of Mueller's smooth muscle fibres. Although all myelinated nerve fibres in the intermuscular connective tissues among the sympathetically innervated Mueller's multi-unit smooth muscle fibres may not correspond to the proprioceptive nerve fibres, the nerve bundles consisting of multiple myelinated nerve fibres were well distributed in the proximal Mueller's muscle, and single myelinated nerve fibres were well distributed in the middle and distal Mueller's muscle. We believe that the mechanoreceptors in Mueller's muscle consist of myelinated proprioceptive nerve fibres with nerve endings possibly attached to collagen fibres in the intermuscular connective tissues present among Mueller's smooth muscle fibres. As the myelinated nerve fibres innervate the middle and distal Mueller's muscle to a greater extent than those in the proximal Mueller's muscle, the former may be more important as mechanoreceptors than the latter and should not be invalidated or excised during surgery for treatment of blepharoptosis to

  12. Stereoscopic Three-Dimensional Images of an Anatomical Dissection of the Eyeball and Orbit for Educational Purposes

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    Full Text Available The purpose of this study was to develop a series of stereoscopic anatomical images of the eye and orbit for use in the curricula of medical schools and residency programs in ophthalmology and other specialties. Layer-by-layer dissection of the eyelid, eyeball, and orbit of a cadaver was performed by an ophthalmologist. A stereoscopic camera system was used to capture a series of anatomical views that were scanned in a panoramic three-dimensional manner around the center of the lid fissure. The images could be rotated 360 degrees in the frontal plane and the angle of views could be tilted up to 90 degrees along the anteroposterior axis perpendicular to the frontal plane around the 360 degrees. The skin, orbicularis oculi muscle, and upper and lower tarsus were sequentially observed. The upper and lower eyelids were removed to expose the bulbar conjunctiva and to insert three 25-gauge trocars for vitrectomy at the location of the pars plana. The cornea was cut at the limbus, and the lens with mature cataract was dislocated. The sclera was cut to observe the trocars from inside the eyeball. The sclera was further cut to visualize the superior oblique muscle with the trochlea and the inferior oblique muscle. The eyeball was dissected completely to observe the optic nerve and the ophthalmic artery. The thin bones of the medial and inferior orbital wall were cracked with a forceps to expose the ethmoid and maxillary sinus, respectively. In conclusion, the serial dissection images visualized aspects of the local anatomy specific to various procedures, including the levator muscle and tarsus for blepharoptosis surgery, 25-gauge trocars as viewed from inside the eye globe for vitrectomy, the oblique muscles for strabismus surgery, and the thin medial and inferior orbital bony walls for orbital bone fractures.

  13. 保留"眼台"的睑袋修复术%Repair of baggy deformity with lower eyelid step reservation

    Institute of Scientific and Technical Information of China (English)

    乔锋丽; 陈兵; 张维娜; 白南; 柳大烈; 王飏; 安阳; 袁继龙


    目的 探讨保留"眼台"的睑袋修复方法 及效果.方法 通过睑缘切口,采用皮瓣与肌皮瓣联合的方法 适当保留睑板前眼轮匝肌,并对眶隔前眼轮匝肌和眼轮匝肌眶部、眶隔及眶隔脂肪行适当处理,去除适量的皮肤,在保留"眼台"的同时修复睑袋.结果 本组58例受术者,术后随访6~24个月,下睑形态良好,外观自然,富有立体感,效果满意.结论 保留"眼台"的睑袋修复方法,在解决下睑袋状突出问题的同时,能使下睑外观更自然,更符合美学要求,使眼部更年轻.%Objective To explore the operation method and effect of repairing baggy deformity with lower eyelid step reservation. Methods The method of skin flap and musculo cutaneous flap with pretarsal orbicularis oculi reservation was adopted through palpebral margin incision, then the preseptal orbicularis oculi and orbital part , orbital septum and orbital septum fat of orbitalis muscle were treated suitably to remove appropriate amount of skin. The lower eyelid step was reserved and repair of blepharoptosis was performed simultaneously.Results Fifty-eight patients were followed up for 6 ~ 24 months, and all were satisfied with good shaped eyelid , natural and spatial construe, which more met aesthetic requirements and looked younger. Conclusion The method of repairing baggy deformity with lower eyelid step reservation could not only solve problem of eye bags , which produces a more desirable appearance, but also meet aesthetic requirements and rejuvenative appearance.

  14. Corrección de ptosis palpebral por la incisión de blefaroplastia Upper eyelid ptosis treatment using blepharoplasty incision

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    A. Novo Torres


    y por tanto la recuperación es mas rápida; posibilita también la cirugía de rescate en caso de correcciones insuficientes y evita el problema de sobrecorrección con exceso de resección de tejido conjuntival. En resumen se trata de una modificación quirúrgica que facilita la técnica, disminuye las complicaciones postoperatorias, mejora la recuperación y evita la sensación de cuerpo extraño intraocular de una resección conjuntivalBlepharoptosis is the abnormally low of the top eyelid during the direct look. Best results are obtained by resection or advance of the elevator muscle or aponeurosis, whenever the elevator has a suitable function. We present a modification to the Blaskovics´s technique for correction of moderate blepharoptosis, with good function of the elevator muscle. We present a serie of 10 cases where we used a variant of Blaskovics’s technique of resection of the elevator for surgical correction of ptosis. Seven were bilateral cases and 3 unilateral ones. In all the cases the elevator function was between 4 and 8 mm and ptosis was major than 4mm with visual field decrease in the direct look. Surgical technique included a cutaneous horizontal incision of Blepharoplasty, wide exhibition of elevator muscle and aponeurosis, respecting orbicular fatty bags and separating it from the palpebral conjunctive. In all the cases correction of the ptosis were obtained. The grade of asymmetry was lower than 0,3 cm. One case presented in the inmediate postoperatory opening of the suture in his medial side and had to be re-taken after 10 days. The palpebral postoperative edema was solved between 2 – 8th day allowing evaluation in that moment. Patient’s satisfaction was good or very good and the visual field was complete in all patients Classic surgical techniques and its modifications for correction of ptosis keep on being valid. With this modification that respects conjuctive we avoid to add morbidity to the surgical process. We think that

  15. 上睑下垂矫正术后发生角膜溃疡的特殊原因及处理%The cause and treatment for corneal ulcer after ptosis surgery

    Institute of Scientific and Technical Information of China (English)

    叶琳; 彭云; 王媛; 路璐; 郭萍; 曾琨


    目的 探讨上睑下垂术后角膜溃疡发生的特殊原因及处理措施.方法 回顾性分析深圳市眼科医院2012年1月至2013年12月进行的上睑下垂矫正术89例(110眼),其中5例(6眼)发生了角膜溃疡,分析其原因及治疗效果.结果 5例(6眼)发生角膜溃疡,3例是因为术后下睑倒睫加重而引起,1例与心因性疾病有关,1例是因为脑膜瘤术后,角膜营养不良引起.进行了睑裂缝合、营养角膜、对症治疗等处理,患者角膜均恢复透明,上睑下垂手术效果满意.结论 上睑下垂患者虽然在术前、术后均采取措施避免角膜溃疡的发生因素,但还是有少数患者术后发生角膜溃疡,其原因并不常见.术前完善检查,术后出现溃疡后积极处理,是可以避免或治愈角膜溃疡的.%Objective To analyze special cause and treatment for corneal ulcer after ptosis surgery.Methods 110 eyes of 89 patients who underwent blepharoptosis correction surgery between January 2012 and December 2012 were retrospectively analyzed.Corneal ulcer occurred in 5 cases (6 eyes).The causes and treatment were analyzed.Results In 5 cases (6 eyes),corneal ulcer was caused by entropion and trichiasis in 3 eyes of 3 cases.The corneal ulcer was related to the psychological illness in 2 eyes of 1 case.The nerve nutritional corneal ulcer occurred in 1 eye of 1 case because of meningioma surgery.After the treatments,such as tarsorrhaphy,cornea nutritional therapy and symptomatic treatment,all the corneal ulcer restored transparent and the effect of surgery was satisfactory.Conclusion Before and after ptosis surgery,patients have been taken measures to prevent the occurrence of corneal ulcer,but corneal ulear still occurs.The causes are not common.So improving preoperative examinations and postoperative active treatment are very necessary.

  16. Clinical analysis on 8 cases with Turner syndrome%8例Tumer综合征临床分析

    Institute of Scientific and Technical Information of China (English)

    刘德云; 杨俐琦; 蒋惠珍; 张志红; 周美玲; 李桢


    目的:提高临床医生对Turner综合征的认识.方法:分析Turner综合征临床和辅助检查特点.结果:所有患者都有矮小,乳房发育不良或不发育,同时伴有黑痣增多5例,发际低5例,眼裂不等大l例,眼睑下垂4例,鼻梁低平2例,颈蹼4例,乳头问距明显增宽5例,明显肘外翻4例.性腺BUS:2例子宫、卵巢发育不良,3例子宫卵巢显示不清,3例子宫、卵巢未显示.染色体核型分析:45,XO 4例;45XO/46 XX 2例;46,X,i(Xq)1例;46,X,del(Xq)1例.骨龄:8例均提示骨龄落后,平均1~3年.其中2例有第4掌骨短小.生长激素激发试验:1例激发试验生长激素水平正常,5例生长激素部分缺乏,2例生长激素完全缺乏.结论:Turner综合征具有典型的临床特点,临床发病率高,提高对本病认识,及时进行染色体核型分析可以确诊.早期诊断、及时治疗对增加患者终身高,提高Turner综合征患者的生活质量有重要意义.%Objective: To improve the cognition of clinical doctors to Turner syndrome. Methods: The clinical and examination characteristics of Turner syndrome were analysed. Results: All the cases were short, mammary dysplasia or agenesis, and 5 eases of more moles, 5 cases of low hairline, 1 case of different oculi rimae, 4 cases of blepharoptosis, 2 cases of low and fiat bridge of the nose, 4 ca-ses of webbed neck, 5 eases of wide distance of two nipples, 4 cases of valgus cubitus were found. Sex glands BUS found 2 cases of hypo-genesis of uterus and ovary, 3 cases of indiseemible uterus and ovary, 3 cases of invisible uterus and ovary. Karyotype analysis found 4 ca-see of 45, XO; 2 cases of 45XO/46 XX; 1 case of 46, X, i (Xq) and 1 ease of 46, X, del (Xq). Skeletal age detection indicated that all the 8 cases had laggard skeletal age, the mean time was 1 ~ 3 years, and 2 cases were found with a shorter fourth metacarpal.Growth hormone provocative test showed that 1 case was nrmal, 5 eases were deficiency partially, 2 eases were

  17. 儿童急性全植物神经功能不全临床特征及诊断%Clinical characteristics and diagnosis of acute pandysautonomia in childhood

    Institute of Scientific and Technical Information of China (English)

    丁昌红; 王晓慧; 邹丽萍; 吕俊兰; 吴沪生; 伍妘; 王红梅


    ,electroencephalography(EEG),spinal cord MRI and somatosensory evoked potential(SEP)were also performed in some patients.Results Of the 6 patients,1 was male,and 5 were female.The age of onset was from 2.3 to 14.5 years(average 8.2 years).The initial symptoms were gastrointestinal dysfunction in 3 patients and somatic motor dysfunction as their initial had irritability in 1 case,pain in 1 and dysphagia in 1, respectively. Autonomic nerve signs and symptoms:① Skin and mucosa are rough and dry, there was no or little perspiration, alacrimia or little tear in all patients.② Vision problem appeared in 1 patient,blepharoptosis in 3 patients,pupillary abnormality existed in all patients. ③ Gastrointestinal symptoms were present in all patients. Vomiting and constipation were present in 4 patients,diarrhea and constipation were alternatively present in 1 patient,abdominal distention and abdominal pain wer present in 2patients.④ Cardiovascular system manifestations included postural dizziness or syncope in 3 patients, tightness and palpitation in 2 patients.⑤ Urinary dysfunction was present in 4 patients.In addition,mild to moderate somatic motor dysfunction was present in 5 patients,sensory dysfunction in 3 patients.Autonomic nerve function tests were abnormal in all patients.Laboratory findings included serum IgM antibody to herpes simplex virus and antistreptolysin "O" (ASO)test were positive respectively in 1 patient.The immunological markers in CSF were abnormal in 3 patients and the protein level in CSF was slightly elevated in 3 patients.Cranial MRI was slightly abnormal in 4 patients.ECG was slightly abnormal in all patients.EMG was abnormal in 5 patients.SEP was abnormal in 3 patients.Five patients received IVIG therapy.Five patients were followed-up.One patient died,one lost to follow up and one had slight improvement.Significant improvement was seen in 2 patients.Conclusion Acute pandysautonomia in children usually had non-specific symptoms and could affect multiple organs

  18. Efficacy and safety of long-term repeated treatment of facial wrinkles with botulinum toxin A%长期重复应用A型肉毒毒素面部除皱的疗效和安全性评价

    Institute of Scientific and Technical Information of China (English)

    潘卫利; 陆威; 陶小华


    appeared on 1 month post-treatment. Patients' selfevaluation as grade 1 for the improvement of forehead wrinkles, fishtail lines, glabellas wrinkles and nasal dorsum transverse wrinkles, accounted for 100%, 97.1%, 99.8% and 99%, respectively. Correspondingly, cases as grade 2 accounted for 0, 2.9%, 0.2% and 1.0%. Grades 3 to 5 had not been reported. With the repetition of treatment, the efficiency increased. The average of effective duration was (7.8±1.1) months, which lasted longer with the injection times increased (r= 0.256, P= 0.02). Adverse reactions observed in the previous several injections, including ecchymosis, feeling of tightness, rigid expression and severer wrinkles near the injected site, which were mild and the incidence rate decreased after the following injections (r= 0.850, P= 0.01). Severe adverse effects, such as allergic reaction,headache, blepharoptosis and dysraphism of eyes had not happened in all the 52 patients. Conclusion Long-term repeated application of BTXA against facial wrinkles is safe and the efficacy is confirmed. The approach can be applied repeatedly to those who have indications and good tolerance.