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• W2332155462 abstract "In Brief Purpose: To evaluate factors that affect eyelid crease formation before and after frontalis suspension. Design: Nonrandomized, comparative, interventional case series. Methods: Sixty-three patients (125 eyes) with myogenic ptosis were included. Data collected included age, gender, previous surgeries, follow up, as well as pre- and postoperative margin reflex distance, palpebral fissure height, and levator function. Intraoperative maneuvers of incorporation of the levator aponeurosis into the skin closure, conservative fat excision, and conservative skin excision were recorded. Pre- and postoperative eyelid creases were graded by 2 masked, independent observers as “good,” “fair,” or “poor.” Results: The weighted κ coefficient between the graders was 0.68 (95% CI, 0.58–0.79) preoperatively and 0.70 (95% CI, 0.61–0.79) postoperatively. Evaluating preoperative eyelid crease grades, there was no significant difference with regard to age or gender (p = 0.83 or 0.69, respectively). Eyelid crease grade correlated with margin reflex distance (p = 0.0004) and palpebral fissure height (p = 0.002). There was no significant correlation of eyelid crease with levator function (p = 0.104). After frontalis sling, intraoperative maneuvers of incorporation of the levator aponeurosis into the incision, skin preservation, and fat preservation correlated with postoperative eyelid crease (p = 0.0004, 0.059, and 0.033, respectively). Conclusions: Preoperative levator function in patients with adult onset myogenic ptosis may be an inaccurate measure of true levator palpebrae strength. Reliance on levator function alone in decision making for surgical intervention in these patients may be misguided. The inclusion of the intraoperative maneuvers of incorporation of the levator aponeurosis into the skin incision and preservation of fat and skin results in a stronger eyelid crease after frontalis sling surgery. In adult onset myogenic ptosis, eyelid crease is correlated with eyelid height, not levator function. Fat and skin preservation and incorporation of levator aponeurosis into the incision is correlated with eyelid crease after frontalis suspension." @default.
• W2332155462 created "2016-06-24" @default.
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• W2332155462 date "2015-05-01" @default.
• W2332155462 modified "2023-09-27" @default.
• W2332155462 title "Factors Affecting Eyelid Crease Formation Before and After Silicone Frontalis Suspension for Adult-Onset Myogenic Ptosis" @default.
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• W2332155462 doi "https://doi.org/10.1097/iop.0000000000000272" @default.
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