Symmetry of upper eyelid after unilateral blepharoptosis repair with minimally invasive conjoint fascial sheath suspension technique

AIM:To investigate the symmetry of upper eyelid in patients with unilateral mild and moderate blepharoptosis who underwent unilateral minimally invasive combined fascia sheath(CFS)suspension.METHODS:A retrospective study of patients who underwent unilateral minimally invasive CFS suspension surgery between January 2018 and December 2021.Inclusion criteria included unilateral mild and moderate ptosis,good levator muscle function(>9 mm)and follow-up of at least 6mo.Pre-and post-operative symmetry was graded subjectively for marginal reflex distance 1(MRD1),tarsal platform show(TPS)and eyebrow fat span(BFS).A t-test was used to evaluate MRD1,TPS and BFS asymmetry by calculating delta values.The Bézier curve tool of the Image J software was used to extract the upper eyelid contours,where the symmetry was measured by the percentage of overlapping curvatures(POC).RESULTS:Totally 105 patients(105 eyelids)were included(mild group,n=84;moderate group,n=21).Postoperatively,all patients increased MRD1 and decreased TPS in the ptotic eye while maintaining unchanged BFS.The asymmetric delta value for MRD1 was measured to be 1.48±0.86 preoperatively,and it decreased to 0.58±0.67 postoperatively in all cases(P=0.0004).In patients with mild ptosis,the asymmetry value of TPS fell significantly from 1.15±0.62 to 0.68±0.38(P=0.0187).The symmetry of the upper eyelid contour increased in all subgroups of patients,with a POC of 59.39%±13.45%preoperatively and POC of 78.29%±13.80%postoperatively.CONCLUSION:Minimally invasive CFS suspension is proved to be an effective means of improving the symmetry of unilateral ptosis in terms of MRD1(all subgroups),POC(all subgroups)and TPS(only mild group),whereas BFS is unaffected.

The Effect of Vault on Conjunctiva Combined with Fascia Sheath Suspension on the Mobility and Aesthetics of Eyelid in Patients with Ptosis

Objective:To investigate the effect of vault on conjunctiva combined with fascia sheath suspension on the mobility and aesthetics of eyelid in patients with ptosis.Methods:A total of 80 patients with ptosis who were admitted to our hospital from January 2017 to January 2019 were selected as the subjects.They were divided into 2 groups with random number table method,40 cases each.The control group was treated with modified single-incision frontalis fascia flap suspension,and the observation group was treated with vault on conjunctiva combined with fascia sheath suspension.The eyelid margin activity,aesthetics and complications were compared between the two groups.Results:The eyelid margin activity of the observation group after treatment was higher than that of the control group,the difference was statistically significant(P<0.05);the aesthetic satisfaction of the observation group after treatment was 95.00%(38/40)higher than that of the control group 70.00%(28/40)The difference was statistically significant(P<0.05);the incidence of complications in the observation group was 2.50%(1/40)lower than that in the control group 20.00%(8/40),and the difference was statistically significant(P<0.05).Conclusion:Patients with ptosis are treated with superior conjunctival fornix combined with fascia sheath suspension,which can improve the mobility of eyelid margin,and it is more beautiful and has less complications.