Feasibility Analysis Of Application Of Levator Muscle-muller’s Muscle Complex Shortening And Overlap Technique On Severe Blepharoptosis

To prove the feasibility of application of levator muscle-Müller’s musclecomplex shortening and overlap technique on severe blepharoptosis,wecompared the curative effects of levator muscle-Müller’s muscle complexshortening and overlap technique with frontalis muscle flap suspensionoperation used surgical methods on severe blepharoptosis and discussed theadvantages and disadvantages of the levator muscle-Müller’s muscle complexshortening and overlap technique in order to provide further evidence on theselection of suitable procedure.Clinical controlled trial was conducted on35patients who were allocatedto two groups according to the different operative procedures: I. levatormuscle-Müller’s muscle complex shortening and overlap technique,18cases26eyes;II. frontalis muscle flap suspension operation17cases22eyes.Patientswere followed-up during3~12months（average6months）.The long-termclinical effects were observed and evaluated according to the standards asfollows:(1) position of upper lid rim after ptosis correction (2) arc of upperpalpebral rim (3) eyelid closure (4) phenomenon of lagophthalmos indown-gaze (5) double-fold crease (6) mobility of frontalis muscle (7) incidentof exposure keratitis (8) patients satisfaction evaluation.The result is that,six months after surgery,in group I,23out of26werecorrected,2cases partly corrected,1case overly corrected. In group II,17out of22cases were satisfied,3cases partly corrected,2cases overly corrected. Thearc of the two groups were improved greatly,Patients were generally satisfiedvery much.Eye closure in1case of group I,3cases of group II;Lagophthalmos in down-gaze appeared in1case of group I,3cases of group II;Bulbarconjunctiva prolapse in3cases of group II.At last,the conclusion is that:⑴The technique of levator muscle-Müller’smuscle complex shortening and overlap is feasible and effective on severeblepharoptosis, and the surgical method is satisfactory.⑵This method makes upfor the lack of frontalis muscle flap suspension operation,is more in line withthe eyelid physiological anatomy than frontalis muscle flap suspensionoperation,and has many other advantages.For examples,postoperativeappearance is improved;complication rate is low;long-term efficacy isstable,and patients are more satisfactory.