Surgical Techniques

Surgical procedures include: Correction of acquired ptosis may be performed in a number of different ways.

  • Ptosis can be caused by the apneurosis of the levator muscle, nerve abnormalities, trauma, inflammation or lesions of the lid or orbit.
  • Dysfunctions of the levators may occur as a result of a lack of nerve communication being sent to the receptors due to antibodies needlessly attacking and eliminating the neurotransmitter.
  • Ptosis may be due to a myogenic, neurogenic, aponeurotic, mechanical or traumatic cause and it usually occurs isolated, but may be associated with various other conditions, like immunological, degenerative, or hereditary disorders, tumors, or infections.
  • Acquired ptosis is most commonly caused by aponeurotic ptosis. This can occur as a result of senescence, dehiscence or disinsertion of the levator aponeurosis. Moreover, chronic inflammation or intraocular surgery can lead to the same effect. Also, wearing contact lenses for long periods of time is thought to have a certain impact on the development of this condition.
  • Congenital neurogenic ptosis is believed to be caused by the Horner syndrome.
  • In this case, a mild ptosis may be associated with psilateral ptosis, iris and areola hypopigmentation and anhidrosis due to the paresis of the Mueller muscle. Acquired Horner syndrome may result after trauma, neoplastic insult, or even vascular disease.
  • Ptosis due to trauma can ensue after an eyelid laceration with transection of the upper eyelid elevators or disruption of the neural input.
  • Other causes of ptosis include eyelid neoplasms, neurofibromas or the cicatrization after inflammation or surgery. Mild ptosis may occur with aging.

Levator resection (Anterior/External approach)

  • Skin incision
  • Adjustment is based on eyelid position during surgery patient is awake
  • May be combined with cosmetic upper blepharoplasty

Müller muscle resection  (Poster / Internal approach)

  • Ideal for patients with minimal excess skin
  • No visible skin incision
  • May be combined with cosmetic upper blepharoplasty
  • Candidates for this procedure respond to 2.5% phenylephine place behind the upper eyelid. See slider animation below.

Frontalis sling operation

  • The idea of the frontalis sling procedure is to transfer the elevating function of the ptotic eyelid to the frontalis muscle.
  • Required when the degree of ptosis is severe
  • To achieve this, the eyelid is directly suspended to the brow using various materials.Creates a ‘sling’ from the frontalis muscle (brow) to the eyelid.
    • synthetic materials, such as ptoseup, Supramid suture, Gortex, silicone, or Mersilene mesh may also be used.
    • Fascia (autogenous or donor using material such as BioElevation™ Ptosis Slings
  • performed for congenital ptosis
  • Because the sling material has little elasticity, a tethering effect on downgaze, Lagophthalmosxare expected postoperatively
  • Allows patient to be asleep since surgical repair is based on formula

Treatment Details Surgery Animated Surgical steps of Ptosis Surgery

 

Treatment Details Surgery Videos of Ptosis Surgery

 

 

 

Non-surgical modalities like the use of "crutch" glasses or special Scleral contact lenses to support the eyelid may also be used.

Procedures
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