Corrección de ptosis palpebral por la incisión de blefaroplastia

Abstract

Blepharoptosis is the abnormally low of the top eyelid during the direct look. Best results are obtained by resection or advance of the elevator muscle or aponeurosis, whenever the elevator has a suitable function. We present a modification to the Blaskovics's technique for correction of moderate blepharoptosis, with good function of the elevator muscle. We present a serie of 10 cases where we used a variant of Blaskovics's technique of resection of the elevator for surgical correction of ptosis. Seven were bilateral cases and 3 unilateral ones. In all the cases the elevator function was between 4 and 8 mm and ptosis was major than 4mm with visual field decrease in the direct look. Surgical technique included a cutaneous horizontal incision of Blepharoplasty, wide exhibition of elevator muscle and aponeurosis, respecting orbicular fatty bags and separating it from the palpebral conjunctive. In all the cases correction of the ptosis were obtained. The grade of asymmetry was lower than 0,3 cm. One case presented in the inmediate postoperatory opening of the suture in his medial side and had to be re-taken after 10 days. The palpebral postoperative edema was solved between 2 - 8th day allowing evaluation in that moment. Patient's satisfaction was good or very good and the visual field was complete in all patients Classic surgical techniques and its modifications for correction of ptosis keep on being valid. With this modification that respects conjuctive we avoid to add morbidity to the surgical process. We think that conjunctive integrity produces a major postoperative comfort to the patient, diminishes the edema and improve the recovery; additionally it makes possible the rescue surgery in case of insufficient correction and avoids over-correction with excess of resection of conjuntive tissue. In summary is a surgical modification that facilitates the technique, diminishes postoperative complications, improves the postoperative recovery and avoids the sensation of intraocular strange body of the conjuntival resection.