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Pulley technique may provide alternative to frontalis sling for ptosis repair
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A new surgical technique corrected severe blepharoptosis with good functional and cosmetic results, according to a small study. The technique, in which a flap of the frontalis muscle is advanced to create a pulley with the aponeurosis of the levator muscle, may provide an alternative to frontalis sling techniques for patients with complete ptosis and deep-set eyes, the study authors said.
The technique "avoids malpositions such as pulling the upper eyelid in an anterior plane during maximum opening and ptosis of the eyelashes," said Ramon Medel, MD, and colleagues. They reported their results with the technique in November/December issue of Ophthalmic Plastic & Reconstructive Surgery.
Dr. Medel and colleagues evaluated the outcomes of the technique in five patients. In each case, surgeons advanced the frontalis muscle flap with a pulley created with the aponeurosis of the levator muscle. At 12 months' follow-up, ptosis resolved in all five patients, yielding good aesthetic results, the study authors said.
One case of lagophthalmos with corneal erosion was the only complication, the authors said.