RESUMO
BACKGROUND: The purpose of this work was to determine the effectiveness and possible complications encountered with bilateral fascia lata lid suspension used to correct blepharoptosis in patients with Kearns-Sayre syndrome. METHODS: This was a retrospective study of seven patients with Kearns-Sayre syndrome who had a minimum of 1 year of follow-up. A bilateral fascia lata sling was used to correct the ptosis. Preoperative and postoperative measurements of the vertical lid fissure width (VFW) and marginal reflex distance (MRD) were performed. The Student's t-test was used to analyze the results. RESULTS: The mean preoperative VFW and MRD measurements were 4±2.45 mm and 0.14±0.92 mm, respectively. The mean postoperative VFW and MRD measurements were 7.71±1.85 mm, and 2.86±1.69 mm, respectively. All preoperative and postoperative values were considered to be statistically significant (P<0.01). Adequate elevation of the lids was obtained in all patients, both functionally and aesthetically. All of the patients showed a mild symmetric postoperative inferior version lagophthalmos, and one patient developed corneal ulceration and scarring due to corneal exposure and a weak Bell's phenomenon. CONCLUSION: The surgical technique described to correct the blepharoptosis found in patients with Kearns-Sayre syndrome was found to be efficient and relatively safe. The correction should be conservative to decrease the risk of postoperative corneal damage that occurred in one patient.
RESUMO
BACKGROUND: The aim of this study was to evaluate the efficacy of a one-stage treatment for the blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) using a combination of standard surgical techniques. METHODS: This is a retrospective interventional case series study of 21 BPES patients with a 1-year minimum follow-up period. The one-stage intervention combined three different surgical procedures in the following order: Z-epicanthoplasty for the epicanthus, transnasal wiring of the medial canthal ligaments for the telecanthus, and a bilateral fascia lata sling for ptosis correction. Preoperative and postoperative measurements of the horizontal lid fissure length (HFL), vertical lid fissure width (VFW), nasal intercanthal distance (ICD), and the ratio between the intercanthal distance and the horizontal fissure length (ICD/HFL) were analyzed using Student's t test for paired variables. RESULTS: The mean preoperative measurements were 4.95 ± 1.13 mm for the VFW, 20.90 ± 2.14 mm for the HFL, 42.45 ± 2.19 mm for the ICD, and 2.04 ± 0.14 mm for the ICD/HFL ratio. The mean postoperative measurements were 7.93 ± 1.02 mm for the VFW, 26.36 ± 1.40 mm for the HFL, 32.07 ± 1.96 mm for the ICD, and 1.23 ± 0.09 mm for the ICD/HFL ratio. All these values and their differences were statistically significant (P < 0.0001). All of the patients developed symmetric postoperative inferior version lagophthalmus, a complication that tended to decrease over time. CONCLUSION: One-stage correction of BPES is safe and efficient with the surgical techniques described.