Comparison Of The Curative Effect Of Three Operative Procedures On Moderate And Severe Blepharoptosis

Objective: To compare the long-term curative effects of three surgical techniques on moderate or severe blepharoptosis and to provide the basis for selecting the suitable procedure:Materials and method: Clinical controlled trial was conducted on 36 patients who were allocate to three groups according to the different operative procedures: I .levator palpebrae superioris muscle shortening II . frontalis muscle flap suspension III .fascia lata or suture line suspension of the ptotic eyelid . Patients followed-up during 1 ~5 years, the long-term clinical effects were observed and evaluated according to the standards as follows:(l)position of upper lid rim after ptosis correction (2)symmetry of the upper lid height(3) arc of upper palpebral rim (4)eyelid closure (5)phenomenon of lagophthalmos in down-gaze(6)double-fold crease (7)mobility of frontalis muscle (8)incident of exposure keratitisResults: Ptosis were all corrected in group .7 cases were satisfied in group I except that 5 cases were partly corrected and 1 case failed.6 cases were corrected ,5 cases partly corrected ,and 1 case uncorrected in group . Arc of upper palpebral rim were quite good in most cases. Eyelid Closure were satisfied in most cases except for few cases and no exposure keratitis occurred. Lagophthalmos in down-gaze appeared in 2 cases of group I ,8 cases of group II ,and 3 cases of group . Double-fold crease of upper eyelid disappeared or became shallow in 8 cases of group II ,5 cases of group ,only 1 case of group I .Conclusion: Frontalis muscle suspension to treat severe blepharoptosis achieved stable effect except for the disadvantage of lagophthalmos and invisible double-fold eyelid crease .The curative effect of levator palpebrae superioris muscle shortening depend on selecting the cases with partial function of levator palpebrae superioris muscle. Fascia lata or suture line suspension of the ptotis eyelid can be applied in some special situations due to its simple procedure, though the long-term effect of this operation was not stable .