Maximal Levator Resection Beyond Whitnall’s Ligament in Severe Simple Congenital Ptosis with Poor Levator Function
Wadakarn Wuthisiri,1 Channy Peou,2 Apatsa Lekskul,1 Weerawan Chokthaweesak1 1Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Ophthalmology International University, Phnom Penh, CambodiaCorrespondence: Weerawan Chokthaweesa...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-02-01
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| Series: | Clinical Ophthalmology |
| Subjects: | |
| Online Access: | https://www.dovepress.com/maximal-levator-resection-beyond-whitnalls-ligament-in-severe-simple-c-peer-reviewed-fulltext-article-OPTH |
| _version_ | 1819274095855927296 |
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| author | Wuthisiri W Peou C Lekskul A Chokthaweesak W |
| author_facet | Wuthisiri W Peou C Lekskul A Chokthaweesak W |
| author_sort | Wuthisiri W |
| collection | DOAJ |
| description | Wadakarn Wuthisiri,1 Channy Peou,2 Apatsa Lekskul,1 Weerawan Chokthaweesak1 1Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Ophthalmology International University, Phnom Penh, CambodiaCorrespondence: Weerawan Chokthaweesak, Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchatewi, Bangkok, 10400, Thailand, Tel +66 2 201 2729, Fax +66 2 201 1516, Email weerawan.ch@gmail.comPurpose: To evaluate the functional and cosmetic outcomes, as well as factors that influence surgical success of maximal levator resection beyond Whitnall’s ligament in patients with poor levator function (LF) and severe simple congenital ptosis.Methods: This retrospective interventional study included patients with severe simple congenital ptosis and LF of ≤ 4 mm who had undergone maximal levator resection beyond Whitnall’s ligament with a minimum of 12 months follow-up. Postoperative marginal reflex distance-1 (MRD1) was assessed for functional outcomes as excellent, good, fair and poor. Eyelid contour and the difference in MRD1 between eyes were assessed for symmetrical cosmetic outcomes as excellent, good and poor. Demographic data, factors influencing surgical success and postoperative complications were analyzed.Results: A total of 38 ptotic eyelids in 31 patients were included. Successful surgical outcomes (at least good functional and cosmetic outcomes) were achieved in 26 patients (83.87%) with the mean MRD1 of +3.61 ± 0.27 mm and +3.51 ± 0.17 mm at 1 week and 12 months after surgery, respectively. There were no significant differences in demographic and preoperative data between the successful and unsuccessful surgical outcome groups, mean preoperative ptosis measurements were 4.19 ± 0.20 mm versus 4.72 ± 0.36 mm (p = 0.242) and mean pre-operative LF were 3.16 ± 0.15 mm versus 2.29 ± 0.61 mm (p = 0.561), respectively. The only factor that significantly influenced the surgical success rate was the length of the resected levator muscle. The mean lengths in successful and unsuccessful groups were 18.15 ± 0.44 mm and 14.29 ± 0.94 mm, respectively (p = 0.011).Conclusion: Maximal levator resection beyond Whitnall’s ligament is an effective procedure for severe simple congenital ptosis with poor LF. Refinement of surgical techniques and careful assessment of the optimal resected length for the levator muscle grants successful surgical outcomes.Keywords: simple congenital ptosis, poor levator function, maximal levator resection, Whitnall’s ligament |
| first_indexed | 2024-12-23T23:02:59Z |
| format | Article |
| id | doaj.art-dc826f4c475e48efae52da3082ae45c7 |
| institution | Directory Open Access Journal |
| issn | 1177-5483 |
| language | English |
| last_indexed | 2024-12-23T23:02:59Z |
| publishDate | 2022-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Ophthalmology |
| spelling | doaj.art-dc826f4c475e48efae52da3082ae45c72022-12-21T17:26:52ZengDove Medical PressClinical Ophthalmology1177-54832022-02-01Volume 1644145272998Maximal Levator Resection Beyond Whitnall’s Ligament in Severe Simple Congenital Ptosis with Poor Levator FunctionWuthisiri WPeou CLekskul AChokthaweesak WWadakarn Wuthisiri,1 Channy Peou,2 Apatsa Lekskul,1 Weerawan Chokthaweesak1 1Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Ophthalmology International University, Phnom Penh, CambodiaCorrespondence: Weerawan Chokthaweesak, Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchatewi, Bangkok, 10400, Thailand, Tel +66 2 201 2729, Fax +66 2 201 1516, Email weerawan.ch@gmail.comPurpose: To evaluate the functional and cosmetic outcomes, as well as factors that influence surgical success of maximal levator resection beyond Whitnall’s ligament in patients with poor levator function (LF) and severe simple congenital ptosis.Methods: This retrospective interventional study included patients with severe simple congenital ptosis and LF of ≤ 4 mm who had undergone maximal levator resection beyond Whitnall’s ligament with a minimum of 12 months follow-up. Postoperative marginal reflex distance-1 (MRD1) was assessed for functional outcomes as excellent, good, fair and poor. Eyelid contour and the difference in MRD1 between eyes were assessed for symmetrical cosmetic outcomes as excellent, good and poor. Demographic data, factors influencing surgical success and postoperative complications were analyzed.Results: A total of 38 ptotic eyelids in 31 patients were included. Successful surgical outcomes (at least good functional and cosmetic outcomes) were achieved in 26 patients (83.87%) with the mean MRD1 of +3.61 ± 0.27 mm and +3.51 ± 0.17 mm at 1 week and 12 months after surgery, respectively. There were no significant differences in demographic and preoperative data between the successful and unsuccessful surgical outcome groups, mean preoperative ptosis measurements were 4.19 ± 0.20 mm versus 4.72 ± 0.36 mm (p = 0.242) and mean pre-operative LF were 3.16 ± 0.15 mm versus 2.29 ± 0.61 mm (p = 0.561), respectively. The only factor that significantly influenced the surgical success rate was the length of the resected levator muscle. The mean lengths in successful and unsuccessful groups were 18.15 ± 0.44 mm and 14.29 ± 0.94 mm, respectively (p = 0.011).Conclusion: Maximal levator resection beyond Whitnall’s ligament is an effective procedure for severe simple congenital ptosis with poor LF. Refinement of surgical techniques and careful assessment of the optimal resected length for the levator muscle grants successful surgical outcomes.Keywords: simple congenital ptosis, poor levator function, maximal levator resection, Whitnall’s ligamenthttps://www.dovepress.com/maximal-levator-resection-beyond-whitnalls-ligament-in-severe-simple-c-peer-reviewed-fulltext-article-OPTHsimple congenital ptosispoor levator functionmaximal levator resectionwhitnall’s ligament |
| spellingShingle | Wuthisiri W Peou C Lekskul A Chokthaweesak W Maximal Levator Resection Beyond Whitnall’s Ligament in Severe Simple Congenital Ptosis with Poor Levator Function Clinical Ophthalmology simple congenital ptosis poor levator function maximal levator resection whitnall’s ligament |
| title | Maximal Levator Resection Beyond Whitnall’s Ligament in Severe Simple Congenital Ptosis with Poor Levator Function |
| title_full | Maximal Levator Resection Beyond Whitnall’s Ligament in Severe Simple Congenital Ptosis with Poor Levator Function |
| title_fullStr | Maximal Levator Resection Beyond Whitnall’s Ligament in Severe Simple Congenital Ptosis with Poor Levator Function |
| title_full_unstemmed | Maximal Levator Resection Beyond Whitnall’s Ligament in Severe Simple Congenital Ptosis with Poor Levator Function |
| title_short | Maximal Levator Resection Beyond Whitnall’s Ligament in Severe Simple Congenital Ptosis with Poor Levator Function |
| title_sort | maximal levator resection beyond whitnall rsquo s ligament in severe simple congenital ptosis with poor levator function |
| topic | simple congenital ptosis poor levator function maximal levator resection whitnall’s ligament |
| url | https://www.dovepress.com/maximal-levator-resection-beyond-whitnalls-ligament-in-severe-simple-c-peer-reviewed-fulltext-article-OPTH |
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