Repair of the recurrence of severe congenital ptosis after corrective surgery with conjoint fascia sheath suspension

PAN Er; YU Jian-gang; ZHANG Sheng-chang

doi:10.3969/j.issn.1673-7040.2017.10.003

Abstract：Objective To evaluate the clinical efficacy of conjoint fascia sheath (CFS) suspension in the repair of the recurrence of severe congenital ptosis.Methods From January 2013 to May 2016,conjoint fascia sheath suspension was performed in 80 patients (80 eyes) with recurrence after severe congenital ptosis correction.The double eyelid line was redesigned,the scar tissue at each layer was released and dissociated,the connection of frontal muscle flap to tarsal plate was amputated and anatomical reduction was performed.The eyelid board edge was exposed,and the lower layer of the levator palpebrae superioris muscle was penetrated at the lateral position.With separation toward the fornix along the conjunctiva,the CFS was located between the former 1/3 of the musculi rectus superior and the levator palpebrae superioris muscle.Ptosis was corrected by suturing the superior alar ligament and corresponding levator palpebrae superioris aponeurosis to the upper margin of the tarsal plate with 6-0 nylon thread.The orbital fat was restored and covered on the upper edge of the tarsal plate.Conventional suture was performed to shape the double eyelid.Success was assumed when the height of palpebral fissure measured significantly higher than before.Results All 80 cases were followed up from 3 to 24 months.Good correction was achieved in 75 eyes.In 5 cases,satisfactory results were achieved after reoperation because of the large differences between bilateral eyes.All patients were able to completely close their eyes from 15 to 90 days.Double eyelid radian was natural and the appearance was satisfactory.No other complications occurred.Conclusion The application of conjoint fascia sheath suspension in the repair of recurrence after severe congenital ptosis correction can achieve satisfactory clinical results.