Clinical Effect of Limited Myectomy for the Treatment of Essential Blepharospasm

ABSTRACT

PURPOSE: Limited protractor myectomy was employed through lid crease incision alone and the effect and complications of this surgery were evaluated and compared with those of the conventional method in essential blepharospasm. METHODS: Seven patients who were not responsive to botulinum toxin injection for essential blepharospasm and who were worried about large scars after protractor myectomy underwent limited myectomy through lid crease incision in the upper lid and lateral myectomy in the lower lid. The corrugator and procerus muscles were left in place. RESULTS: Blepharospasm was improved in five of the seven patients after limited myectomy and by botulinum injection in one of the remaining two patients for whom limited myectomy was not successful. Severe lymphedema seen after protractor myectomy through suprabrow incision was not encountered. Long-term lymphedema, skin necrosis, eyebrow loss, and exposure keratitis were reduced and operative time was shorter than that of conventional methods. CONCLUSIONS: Limited myectomy through lid crease incision in essential blepharospasm has less postoperative complications and shorter operative time than conventional surgery.