Surgical Correction of the Blepharophimosis Syndorome

During the past decade the syndorome of blepharoptosis, blepharophimosis, epicanthus inversus and telecanthus(blepharophimosis syndrome)have become recognized as a distinct tetrad based upon clinical and hereditary characteristics. Early surgery is recommended to minimize being teased at school altough the final results surgical correction may be better in older children and in adults. We treated nine patients with epicanthus by Mustarde's quadrilateral flap or Y to V flap Medial canthal tendon is shortened by tucking for telecanthus. Blepharoptosis is corrected by frontalis suspension using preserved dura or preserved fascia lata as a sling material. We experience satisfactory results in nine patients by this technique without serious postoperative complications.

Subconjunctival Fat Prolapse

Subconjunctival fat prolapse is characterized by a yellow, convex, movable mass on the superotemporal quadrant. It is thought that orbital fat is prolapsed forward through the weakened Tenon's capsule, as an aging process. This lesion may be confused with lipodermoid, prolapsed lacrimal gland and lipoma. We report 4 cases (7 eyes) of subconjunctival fat prolapse, all of them were men, aged from 48 to 67 years. After surgical treartment, good cosmesis was obtained with the average follow-up period of 15.5 months.

Two-Wall Orbital Decompression for Endocrine Exophthalmos

We reviewed 17 cases with dysthyroid exophthalmos in 13 patients which were treated with antral-ethmoidal decompression surgery. Transantral approaches were done in 6 orbits of 3 patients and transfornix approaches were done in 11 orbits of 10 patients. The amount of postoperative retroplacement of the globe was 4.3mm in average and ranged from 1mm to 9mm during the average follow-up period of 14.9 months. All patients with compressive optic neuropathy improved in visual acuity by 3 or 4 lines of Hahn test chart. In most patients the restriction of ocular motility was improved and exposure keratitis decreased The cosmetic results were also satisfactory. The postoperative complications were induced diplopia in 2 cases and permanent infraorbital anesthesia in 1 case. The detailed surgical procedures and results were presented and reviewed.