The role of Whitnall’s ligament position in the success of levator resection surgery in congenital ptosis
Abstract Purpose This study aimed to investigate the role of Whitnall’s ligament position in the success of levator resection surgery in congenital ptosis. Methods It was an interventional case series on patients with congenital ptosis who underwent levator muscle resection in Farabi Eye Hospital (2...
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Ophthalmology |
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| Online Access: | https://doi.org/10.1186/s12886-023-03238-z |
| _version_ | 1827590686100160512 |
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| author | Mansooreh Jamshidian Tehrani Abolfazl Kasaee Haniyeh Zeidabadinejad Mansoor Shahriari Seyed Mohsen Rafizadeh |
| author_facet | Mansooreh Jamshidian Tehrani Abolfazl Kasaee Haniyeh Zeidabadinejad Mansoor Shahriari Seyed Mohsen Rafizadeh |
| author_sort | Mansooreh Jamshidian Tehrani |
| collection | DOAJ |
| description | Abstract Purpose This study aimed to investigate the role of Whitnall’s ligament position in the success of levator resection surgery in congenital ptosis. Methods It was an interventional case series on patients with congenital ptosis who underwent levator muscle resection in Farabi Eye Hospital (2020–2022). Patients with incomplete follow-up, a history of trauma, poor Bell’s phenomenon, previous ocular and lid surgeries, poor levator function (≤ 4mm), and syndromic ptosis or systemic diseases were excluded. During the surgery, several factors, including the distance between Whitnall’s ligament and the upper edge of the tarsus (W-distance), the vertical length of the tarsus (T-length), and the amount of levator muscle resection (LMR), were measured. A successful outcome was defined as the inter-eye difference of margin reflex distance-1 (MRD1) ≤ 1 and post-op MRD1 ≥ 3 OR the inter-eye difference of MRD1 ≤ 0.5 with any value of post-op MRD1 in unilateral cases and Postop-MRD1 > 3 in bilateral cases during the 3-months period. Results Thirty four eyes of 34 patients were included, and 79.4% of patients achieved successful outcomes. In univariate analysis, Preop-MRD1 and Preop-LF had meaningful negative correlations with the amount of LMR to reach the successful outcome (p < 0.05), which was only meaningful for Preop-LF in multivariable analysis (p < 0.05). Noticeably, W-distance had a significant positive correlation in univariate and multivariable linear regression (p < 0.05). Conclusions W-distance can be considered a significant new parameter other than Preop-LF influencing the amount of levator resection needed to achieve success in levator resection surgery. |
| first_indexed | 2024-03-09T01:20:18Z |
| format | Article |
| id | doaj.art-352b5a9c64934aff81b0d9761a4f6ea0 |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-03-09T01:20:18Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-352b5a9c64934aff81b0d9761a4f6ea02023-12-10T12:11:39ZengBMCBMC Ophthalmology1471-24152023-12-012311710.1186/s12886-023-03238-zThe role of Whitnall’s ligament position in the success of levator resection surgery in congenital ptosisMansooreh Jamshidian Tehrani0Abolfazl Kasaee1Haniyeh Zeidabadinejad2Mansoor Shahriari3Seyed Mohsen Rafizadeh4Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical SciencesOphthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical SciencesOphthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical SciencesOphthalmology, Imam Hossein Medical Center, Ophthalmic Research Center, Shahid Beheshti University of Medical SciencesOphthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical SciencesAbstract Purpose This study aimed to investigate the role of Whitnall’s ligament position in the success of levator resection surgery in congenital ptosis. Methods It was an interventional case series on patients with congenital ptosis who underwent levator muscle resection in Farabi Eye Hospital (2020–2022). Patients with incomplete follow-up, a history of trauma, poor Bell’s phenomenon, previous ocular and lid surgeries, poor levator function (≤ 4mm), and syndromic ptosis or systemic diseases were excluded. During the surgery, several factors, including the distance between Whitnall’s ligament and the upper edge of the tarsus (W-distance), the vertical length of the tarsus (T-length), and the amount of levator muscle resection (LMR), were measured. A successful outcome was defined as the inter-eye difference of margin reflex distance-1 (MRD1) ≤ 1 and post-op MRD1 ≥ 3 OR the inter-eye difference of MRD1 ≤ 0.5 with any value of post-op MRD1 in unilateral cases and Postop-MRD1 > 3 in bilateral cases during the 3-months period. Results Thirty four eyes of 34 patients were included, and 79.4% of patients achieved successful outcomes. In univariate analysis, Preop-MRD1 and Preop-LF had meaningful negative correlations with the amount of LMR to reach the successful outcome (p < 0.05), which was only meaningful for Preop-LF in multivariable analysis (p < 0.05). Noticeably, W-distance had a significant positive correlation in univariate and multivariable linear regression (p < 0.05). Conclusions W-distance can be considered a significant new parameter other than Preop-LF influencing the amount of levator resection needed to achieve success in levator resection surgery.https://doi.org/10.1186/s12886-023-03238-zPtosisLevator muscle resectionWhitnall’s ligamentLevator functionLevator resection surgery |
| spellingShingle | Mansooreh Jamshidian Tehrani Abolfazl Kasaee Haniyeh Zeidabadinejad Mansoor Shahriari Seyed Mohsen Rafizadeh The role of Whitnall’s ligament position in the success of levator resection surgery in congenital ptosis BMC Ophthalmology Ptosis Levator muscle resection Whitnall’s ligament Levator function Levator resection surgery |
| title | The role of Whitnall’s ligament position in the success of levator resection surgery in congenital ptosis |
| title_full | The role of Whitnall’s ligament position in the success of levator resection surgery in congenital ptosis |
| title_fullStr | The role of Whitnall’s ligament position in the success of levator resection surgery in congenital ptosis |
| title_full_unstemmed | The role of Whitnall’s ligament position in the success of levator resection surgery in congenital ptosis |
| title_short | The role of Whitnall’s ligament position in the success of levator resection surgery in congenital ptosis |
| title_sort | role of whitnall s ligament position in the success of levator resection surgery in congenital ptosis |
| topic | Ptosis Levator muscle resection Whitnall’s ligament Levator function Levator resection surgery |
| url | https://doi.org/10.1186/s12886-023-03238-z |
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