Clinical Examination on the Blepharoptosis and the Resection of the Levator Muscle

The resection of levator aponeurosis and its muscle through the anterior approach had been performed on 50 ptotic lids of 40 patients from April, 1985 to January, 1988. Their age ranged from 28 months to 44 years old(mean, 7.5 years old). All but one of them were congenital origin. Thirty-four per cent of eyes were associated with ocular abnormalities such as strabismus, entropion, and blepharophimosis. Three patients had inguinal hernia, tongue tie, and ventricular septal defect respectively as systemic abonrmalities. The cycloplegic refraction revealed mild hyperopia in 74%, mild myopia in 18%, and moderate or severe hyperopia in 8%. Seventy per cent of eyes had with-the-rule astigmatism, while 8% had againgt-therule astigmatism. Twenty-two per cent had no astigmatism. Amblyopia was noted in 11 patients of 31 patients in whom we could check the visual acuity. The amount of levator muscle resected, which depended on the function of levator muscle and the degree of ptosis, ranged from 15mm to 24mm (mean, 20.2mm). We also applied this procedure to the patient whose levator function was less than 2mm. Good surgical results were obtained in 45 eyes(90%). Undercorrected one eye underwent reoperation using the frontalis sling.

2 Case of Epikeratopkakia in the Adult Aphakia

One of the indications for epikeratophakia is monocular aphakia intolerant of spectacles and contact lens correction and unsuited for intraocular lens implantation for whatever reason. The procedure involves suturing a lamellar corneal stromal tissue of a human donor eye prelathed for corrective power onto the recipient cornea whose epithellum has just been removed. We performed the epikeratophakia procedure on two patients who were included in the above indication on May 26, 1988. Through the first 6 months of postoperative period, both the graft and recipient tissues remained clear with excellent optical quality, with corrected visual acuity of 0.4 at 1 month, 0.6 at 3 month and 0.8 at 6 month postoperative period respectively. The average increase of corneal curvature was 10.5 diopters and induced refractive error was within 1.5 spherical equivalent diopters after the 6 month period. No significant postoperative compications have been encountered.