AIM:To investigate the symmetry of upper eyelid in patients with unilateral mild and moderate blepharoptosis who underwent unilateral minimally invasive combined fascia sheath(CFS)suspension.METHODS:A retrospective st...AIM:To investigate the symmetry of upper eyelid in patients with unilateral mild and moderate blepharoptosis who underwent unilateral minimally invasive combined fascia sheath(CFS)suspension.METHODS:A retrospective study of patients who underwent unilateral minimally invasive CFS suspension surgery between January 2018 and December 2021.Inclusion criteria included unilateral mild and moderate ptosis,good levator muscle function(>9 mm)and follow-up of at least 6mo.Pre-and post-operative symmetry was graded subjectively for marginal reflex distance 1(MRD1),tarsal platform show(TPS)and eyebrow fat span(BFS).A t-test was used to evaluate MRD1,TPS and BFS asymmetry by calculating delta values.The Bézier curve tool of the Image J software was used to extract the upper eyelid contours,where the symmetry was measured by the percentage of overlapping curvatures(POC).RESULTS:Totally 105 patients(105 eyelids)were included(mild group,n=84;moderate group,n=21).Postoperatively,all patients increased MRD1 and decreased TPS in the ptotic eye while maintaining unchanged BFS.The asymmetric delta value for MRD1 was measured to be 1.48±0.86 preoperatively,and it decreased to 0.58±0.67 postoperatively in all cases(P=0.0004).In patients with mild ptosis,the asymmetry value of TPS fell significantly from 1.15±0.62 to 0.68±0.38(P=0.0187).The symmetry of the upper eyelid contour increased in all subgroups of patients,with a POC of 59.39%±13.45%preoperatively and POC of 78.29%±13.80%postoperatively.CONCLUSION:Minimally invasive CFS suspension is proved to be an effective means of improving the symmetry of unilateral ptosis in terms of MRD1(all subgroups),POC(all subgroups)and TPS(only mild group),whereas BFS is unaffected.展开更多
Blepharoptosis is a symptom that is commonly observed in clinics.It presents with drooping of the upper eyelid and an asymmetric appearance of the eye.It can occur because of various causes.If left untreated,severe co...Blepharoptosis is a symptom that is commonly observed in clinics.It presents with drooping of the upper eyelid and an asymmetric appearance of the eye.It can occur because of various causes.If left untreated,severe congenital blepharoptosis may impair visual function.The surgical approach largely depends on the severity of blepharoptosis,Bell’s phenomenon,and surgical history.However,it is intricate and difficult to achieve satisfactory symmetry and avoid complications.Owing to the complexity involved and discrepancies in treatment,we planned to arrive at a consensus on the diagnosis and correction of blepharoptosis among Chinese plastic surgeons and ophthalmologists,aiming to establish more standardized treatments and cause less harm to patients.展开更多
AIM:To investigate the prevalence and types of eyelid disorders among an elderly population in China,underscoring the significance of eyelid health for the aging demographic.METHODS:A cross-sectional epidemiological s...AIM:To investigate the prevalence and types of eyelid disorders among an elderly population in China,underscoring the significance of eyelid health for the aging demographic.METHODS:A cross-sectional epidemiological survey was conducted on 3038 individuals over the age of 50,all of whom were evaluated at the community health center.Each participant underwent routine ophthalmic examinations and eyelid morphology evaluations by an ophthalmologist.Eyelid disorders and morphology were assessed through slit-lamp examination and direct visual inspection.The study analyzed the characteristics of common eyelid disorders,including blepharoptosis,dermatochalasis,eyelid tumors,entropion,lower eyelid retraction(LER)and ectropion,as well as eyelid morphologies such as sunken and bulging eyelids.Descriptive statistics were used for demographic data,Chi-square test analyzed gender distribution differences,and logistic regression calculated odds ratios for blepharoptosis(P<0.05 considered significant).RESULTS:The study revealed that eyelid disorders were present in 1250(41%)individuals,with blepharoptosis being the most common disorder(25%),followed by severe dermatochalasis(16%),eyelid tumors(9.3%),LER and ectropion(11%),and entropion(1.2%).Sunken eyelids were more prevalent in men(26%)than in women(17%).The study found significant associations between the presence of blepharoptosis and sunken upper eyelids[P=0.01,odds ratio(OR)=1.33],as well as male gender(P=0.038,OR=1.22).Additionally,the prevalence of blepharoptosis increased with age.CONCLUSION:Eyelid disorders are highly prevalent in older people and increase steeply with age.This study highlights the need for increased awareness of eyelid health among older individuals at risk for eyelid disorders and the importance of ophthalmic examination for early diagnosis and management of these disorders.展开更多
Background Congenital blepharoptosis(CBP)may be part of a large spectrum of birth defects presenting with other ocular or systemic conditions.Therefore,the aim of the study was to investigate the incidence of congenit...Background Congenital blepharoptosis(CBP)may be part of a large spectrum of birth defects presenting with other ocular or systemic conditions.Therefore,the aim of the study was to investigate the incidence of congenital heart diseases(CHD)in CBP children not associated with specific syndromes.Methods A total of 1053 Chinese children diagnosed with non-syndromic CBP were consecutively enrolled and their cardiac structure was evaluated by echocardiography.Results Forty children were identified with CHD.Twenty-four children had one type of structural malformation(simple CHD).Sixteen children had two or more types of structural malformation(complex CHD).CHD and complex CHD were more prevalent in patients with severe or bilateral ptosis.Multivariate analysis revealed that presence of severe ptosis and bilateral ptosis was independently associated with CHD occurrence.Conclusions We found an increased frequency of CHD in CBP children,suggesting a clinical need for routine echocardiography evaluation in CBP,especially in children with severe or bilateral ptosis.展开更多
Blepharoptosis is present when the upper eyelid is lower than its normal anatomic position in primary gaze.This is secondary to a neuromuscular imbalance with weakening of the upper eyelid retractors in relation to th...Blepharoptosis is present when the upper eyelid is lower than its normal anatomic position in primary gaze.This is secondary to a neuromuscular imbalance with weakening of the upper eyelid retractors in relation to the protractors.As the degree of ptosis worsens,significant functional and cosmetic concerns often arise.To adequately address these concerns,ptosis is divided into categories based on the underlying pathogenesis:aponeurotic,myogenic,neurogenic,mechanical,or traumatic.Within these categories,it is important to determine if the ptosis is congenital or acquired as diagnostic and therapeutic approaches often vary between these two distinctions.The goal of this review is to summarize the classification,evaluation,management,and potential pitfalls of both acquired and congenital ptosis.展开更多
AIM： To study the influence of frontalis muscle flap suspension on ocular surface by analyzing the clinical features and inflammatory cytokines.METHODS： A prospective, observational case series. Thirty-one eyes of 2...AIM： To study the influence of frontalis muscle flap suspension on ocular surface by analyzing the clinical features and inflammatory cytokines.METHODS： A prospective, observational case series. Thirty-one eyes of 25 patients with severe congenital blepharoptosis who underwent frontalis muscle flap suspension surgery with at least 6 mo of follow-up were included in the study. The main outcome measures were margin reflex distance 1（MRD_1）, degree of lagophthalmos, ocular surface disease index（OSDI）, fluorescein staining（Fl）, tear break-up time（BUT）, Schirmer I test, and inflammatory cytokine assay.RESULTS： The degrees of lagophthalmos significantly increased after surgery. The OSDI scores significantly increased 1wk postoperatively and then decreased 4wk after operation. The Fl scores reflected corneal epithelial defects in sixteen patients at early stage postoperatively. The BUT and Schirmer I test values remained stable and did not show change compared to those before surgery. The inflammatory cytokines in conjunctival epithelial cells（including IL-1β, IL-6, IL-8, TNF-α, and IL-17A） significantly increased 1wk after the surgery（P〈0.001）, then returned to the normal level at 24wk postoperatively. The levels of inflammatory cytokine IL-1β, IL-6, IL-8, TNF-α, and IL-17A elevated significantly and were positively correlated with OSDI and Fl scores.CONCLUSION： Frontalis muscle flap suspension surgery results in lagophthalmos in early period of post-operation and relieved after months. The elevation of inflammatory cytokines level may participate in the occurrence of corneal epithelial defects at the early postoperative stage.展开更多
Fengchi (GB 20) is a point of the Gallbladder Channel of Foot-Shaoyang. Just as its name implies that it is a place where the pathogenic wind converges. So, the point is regarded as an important point to dispel wind s...Fengchi (GB 20) is a point of the Gallbladder Channel of Foot-Shaoyang. Just as its name implies that it is a place where the pathogenic wind converges. So, the point is regarded as an important point to dispel wind since it has the functions of clearing heat and brightening the eye, dispelling wind and inducing resuscitation.展开更多
Periorbital rejuvenation is a common aesthetic goal sought by patients presenting to the plastic or oculoplastic surgeon.For this reason,it is critical that the surgeon understand the functional considerations,such as...Periorbital rejuvenation is a common aesthetic goal sought by patients presenting to the plastic or oculoplastic surgeon.For this reason,it is critical that the surgeon understand the functional considerations,such as preexisting blepharoptosis,which will contribute to the ultimate aesthetic outcome.This article will review the anatomy of the normal and ptotic lid and will discuss the approach to diagnosing and characterizing the type and degree of lid ptosis.High-yield surgical techniques for ptosis correction will then be described,including the indications for and steps of each procedure.Finally,the diagnosis and management of common complications that follow ptosis surgery will be discussed.Our main objective is to arm the surgeon with the preoperative and operative planning tools to successfully manage comorbid ptosis and thereby improve blepharoplasty outcomes.展开更多
基金Supported by Tianjin Key Medical Discipline Construction Project(No.TJYXZDXK-016A).
文摘AIM:To investigate the symmetry of upper eyelid in patients with unilateral mild and moderate blepharoptosis who underwent unilateral minimally invasive combined fascia sheath(CFS)suspension.METHODS:A retrospective study of patients who underwent unilateral minimally invasive CFS suspension surgery between January 2018 and December 2021.Inclusion criteria included unilateral mild and moderate ptosis,good levator muscle function(>9 mm)and follow-up of at least 6mo.Pre-and post-operative symmetry was graded subjectively for marginal reflex distance 1(MRD1),tarsal platform show(TPS)and eyebrow fat span(BFS).A t-test was used to evaluate MRD1,TPS and BFS asymmetry by calculating delta values.The Bézier curve tool of the Image J software was used to extract the upper eyelid contours,where the symmetry was measured by the percentage of overlapping curvatures(POC).RESULTS:Totally 105 patients(105 eyelids)were included(mild group,n=84;moderate group,n=21).Postoperatively,all patients increased MRD1 and decreased TPS in the ptotic eye while maintaining unchanged BFS.The asymmetric delta value for MRD1 was measured to be 1.48±0.86 preoperatively,and it decreased to 0.58±0.67 postoperatively in all cases(P=0.0004).In patients with mild ptosis,the asymmetry value of TPS fell significantly from 1.15±0.62 to 0.68±0.38(P=0.0187).The symmetry of the upper eyelid contour increased in all subgroups of patients,with a POC of 59.39%±13.45%preoperatively and POC of 78.29%±13.80%postoperatively.CONCLUSION:Minimally invasive CFS suspension is proved to be an effective means of improving the symmetry of unilateral ptosis in terms of MRD1(all subgroups),POC(all subgroups)and TPS(only mild group),whereas BFS is unaffected.
文摘Blepharoptosis is a symptom that is commonly observed in clinics.It presents with drooping of the upper eyelid and an asymmetric appearance of the eye.It can occur because of various causes.If left untreated,severe congenital blepharoptosis may impair visual function.The surgical approach largely depends on the severity of blepharoptosis,Bell’s phenomenon,and surgical history.However,it is intricate and difficult to achieve satisfactory symmetry and avoid complications.Owing to the complexity involved and discrepancies in treatment,we planned to arrive at a consensus on the diagnosis and correction of blepharoptosis among Chinese plastic surgeons and ophthalmologists,aiming to establish more standardized treatments and cause less harm to patients.
基金Supported by the National Natural Science Foundation of China(No.82101176)Natural Science Foundation of Zhejiang Province(No.LTGD23H120002).
文摘AIM:To investigate the prevalence and types of eyelid disorders among an elderly population in China,underscoring the significance of eyelid health for the aging demographic.METHODS:A cross-sectional epidemiological survey was conducted on 3038 individuals over the age of 50,all of whom were evaluated at the community health center.Each participant underwent routine ophthalmic examinations and eyelid morphology evaluations by an ophthalmologist.Eyelid disorders and morphology were assessed through slit-lamp examination and direct visual inspection.The study analyzed the characteristics of common eyelid disorders,including blepharoptosis,dermatochalasis,eyelid tumors,entropion,lower eyelid retraction(LER)and ectropion,as well as eyelid morphologies such as sunken and bulging eyelids.Descriptive statistics were used for demographic data,Chi-square test analyzed gender distribution differences,and logistic regression calculated odds ratios for blepharoptosis(P<0.05 considered significant).RESULTS:The study revealed that eyelid disorders were present in 1250(41%)individuals,with blepharoptosis being the most common disorder(25%),followed by severe dermatochalasis(16%),eyelid tumors(9.3%),LER and ectropion(11%),and entropion(1.2%).Sunken eyelids were more prevalent in men(26%)than in women(17%).The study found significant associations between the presence of blepharoptosis and sunken upper eyelids[P=0.01,odds ratio(OR)=1.33],as well as male gender(P=0.038,OR=1.22).Additionally,the prevalence of blepharoptosis increased with age.CONCLUSION:Eyelid disorders are highly prevalent in older people and increase steeply with age.This study highlights the need for increased awareness of eyelid health among older individuals at risk for eyelid disorders and the importance of ophthalmic examination for early diagnosis and management of these disorders.
基金This work was supported by the National Natural Science Foundation of China grant(Grant no.81570037)the MDT Program of Shanghai Ninth People’s Hospital(Grant no.2017-1-015).
文摘Background Congenital blepharoptosis(CBP)may be part of a large spectrum of birth defects presenting with other ocular or systemic conditions.Therefore,the aim of the study was to investigate the incidence of congenital heart diseases(CHD)in CBP children not associated with specific syndromes.Methods A total of 1053 Chinese children diagnosed with non-syndromic CBP were consecutively enrolled and their cardiac structure was evaluated by echocardiography.Results Forty children were identified with CHD.Twenty-four children had one type of structural malformation(simple CHD).Sixteen children had two or more types of structural malformation(complex CHD).CHD and complex CHD were more prevalent in patients with severe or bilateral ptosis.Multivariate analysis revealed that presence of severe ptosis and bilateral ptosis was independently associated with CHD occurrence.Conclusions We found an increased frequency of CHD in CBP children,suggesting a clinical need for routine echocardiography evaluation in CBP,especially in children with severe or bilateral ptosis.
文摘Blepharoptosis is present when the upper eyelid is lower than its normal anatomic position in primary gaze.This is secondary to a neuromuscular imbalance with weakening of the upper eyelid retractors in relation to the protractors.As the degree of ptosis worsens,significant functional and cosmetic concerns often arise.To adequately address these concerns,ptosis is divided into categories based on the underlying pathogenesis:aponeurotic,myogenic,neurogenic,mechanical,or traumatic.Within these categories,it is important to determine if the ptosis is congenital or acquired as diagnostic and therapeutic approaches often vary between these two distinctions.The goal of this review is to summarize the classification,evaluation,management,and potential pitfalls of both acquired and congenital ptosis.
基金Supported by the National Natural Science Foundation of China(No.81670823)
文摘AIM： To study the influence of frontalis muscle flap suspension on ocular surface by analyzing the clinical features and inflammatory cytokines.METHODS： A prospective, observational case series. Thirty-one eyes of 25 patients with severe congenital blepharoptosis who underwent frontalis muscle flap suspension surgery with at least 6 mo of follow-up were included in the study. The main outcome measures were margin reflex distance 1（MRD_1）, degree of lagophthalmos, ocular surface disease index（OSDI）, fluorescein staining（Fl）, tear break-up time（BUT）, Schirmer I test, and inflammatory cytokine assay.RESULTS： The degrees of lagophthalmos significantly increased after surgery. The OSDI scores significantly increased 1wk postoperatively and then decreased 4wk after operation. The Fl scores reflected corneal epithelial defects in sixteen patients at early stage postoperatively. The BUT and Schirmer I test values remained stable and did not show change compared to those before surgery. The inflammatory cytokines in conjunctival epithelial cells（including IL-1β, IL-6, IL-8, TNF-α, and IL-17A） significantly increased 1wk after the surgery（P〈0.001）, then returned to the normal level at 24wk postoperatively. The levels of inflammatory cytokine IL-1β, IL-6, IL-8, TNF-α, and IL-17A elevated significantly and were positively correlated with OSDI and Fl scores.CONCLUSION： Frontalis muscle flap suspension surgery results in lagophthalmos in early period of post-operation and relieved after months. The elevation of inflammatory cytokines level may participate in the occurrence of corneal epithelial defects at the early postoperative stage.
文摘Fengchi (GB 20) is a point of the Gallbladder Channel of Foot-Shaoyang. Just as its name implies that it is a place where the pathogenic wind converges. So, the point is regarded as an important point to dispel wind since it has the functions of clearing heat and brightening the eye, dispelling wind and inducing resuscitation.
文摘Periorbital rejuvenation is a common aesthetic goal sought by patients presenting to the plastic or oculoplastic surgeon.For this reason,it is critical that the surgeon understand the functional considerations,such as preexisting blepharoptosis,which will contribute to the ultimate aesthetic outcome.This article will review the anatomy of the normal and ptotic lid and will discuss the approach to diagnosing and characterizing the type and degree of lid ptosis.High-yield surgical techniques for ptosis correction will then be described,including the indications for and steps of each procedure.Finally,the diagnosis and management of common complications that follow ptosis surgery will be discussed.Our main objective is to arm the surgeon with the preoperative and operative planning tools to successfully manage comorbid ptosis and thereby improve blepharoplasty outcomes.
