Semi-adjustable posterior approach for congenital ptosis repair- outcomes of local and general anesthesia

To report a single center experience with semi-adjustable posterior approach levator plication ('levatorpexy') in patients with congenital ptosis. A retrospective study. All cases who underwent posterior approach levatorpexy for congenital ptosis between the years 2016 to 2022 were include...

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Published inEuropean journal of ophthalmology p. 11206721241247426
Main Authors Ben Ishai, Meydan, Ben Artsi, Elad, Shouchane-Blum, Karny, Kramarz Dadon, Judith, Avisar, Inbal
Format Journal Article
LanguageEnglish
Published United States 11.04.2024
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Abstract To report a single center experience with semi-adjustable posterior approach levator plication ('levatorpexy') in patients with congenital ptosis. A retrospective study. All cases who underwent posterior approach levatorpexy for congenital ptosis between the years 2016 to 2022 were included. The primary outcome measures were margin-to-reflex distance 1 (MRD1) before and after surgery, upper eyelid contour, symmetry of upper eyelid height, complications, and surgical success. Surgery was successful if all the following criteria were met: A postoperative MRD1 of ≥2 mm and ≤4.5 mm, a satisfactory eyelid contour in the operated eyelid, and an inter-eyelid MRD1 asymmetry of ≤1 mm. Postoperative modifications in semi-adjustable techniques were considered in all cases. Twenty-three eyelids of 21 patients were included, 11 were performed under general anesthesia, and 12 were performed under local anesthesia. The mean age of all patients was 24.1 years (8-47 years). The mean levator function was 11.2 (±2.11). Mean preoperative MRD1 was 1.05 mm and 1.41 for general and local anesthesia, respectively. Mean postoperative MRD1 was 3.33 mm and 3.37 mm for general and local anesthesia, respectively. Eighteen patients (85%) achieved the desired eyelid height and fulfilled our criteria for success. There were no complications reported in any of the groups. Posterior approach levatorpexy is a safe and effective procedure for repairing congenital ptosis in patients with good levator function. This technique is suitable for young patients and those unable to undergo surgery under local anesthesia. This technique offers post-operative modification due to its semi-adjustable nature.
AbstractList To report a single center experience with semi-adjustable posterior approach levator plication ('levatorpexy') in patients with congenital ptosis. A retrospective study. All cases who underwent posterior approach levatorpexy for congenital ptosis between the years 2016 to 2022 were included. The primary outcome measures were margin-to-reflex distance 1 (MRD1) before and after surgery, upper eyelid contour, symmetry of upper eyelid height, complications, and surgical success. Surgery was successful if all the following criteria were met: A postoperative MRD1 of ≥2 mm and ≤4.5 mm, a satisfactory eyelid contour in the operated eyelid, and an inter-eyelid MRD1 asymmetry of ≤1 mm. Postoperative modifications in semi-adjustable techniques were considered in all cases. Twenty-three eyelids of 21 patients were included, 11 were performed under general anesthesia, and 12 were performed under local anesthesia. The mean age of all patients was 24.1 years (8-47 years). The mean levator function was 11.2 (±2.11). Mean preoperative MRD1 was 1.05 mm and 1.41 for general and local anesthesia, respectively. Mean postoperative MRD1 was 3.33 mm and 3.37 mm for general and local anesthesia, respectively. Eighteen patients (85%) achieved the desired eyelid height and fulfilled our criteria for success. There were no complications reported in any of the groups. Posterior approach levatorpexy is a safe and effective procedure for repairing congenital ptosis in patients with good levator function. This technique is suitable for young patients and those unable to undergo surgery under local anesthesia. This technique offers post-operative modification due to its semi-adjustable nature.
Author Ben Artsi, Elad
Kramarz Dadon, Judith
Shouchane-Blum, Karny
Ben Ishai, Meydan
Avisar, Inbal
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  givenname: Inbal
  surname: Avisar
  fullname: Avisar, Inbal
  organization: Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Keywords Ptosis
adjustable
levtorpexy
anesthesia
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