The Clinical Study of 33 Cases of Congenital Blepharoptosis

ABSTRACT

The blepharoptosis is drooping of upper eyelid in primary gaze with various causes. The most common cause of ptosis is, in known as, underdevelopment of levator muscle. We evaluated the age and sexual distribution, clinical manifestation, result of treatment and it's complication of congenital blepharoptosis. The method of surgery and amount of muscle resection was decided according to several factors that is the amount of ptosis, the preoperative levator functon, and the Margin Limbal Distance(MLD). Most of patient was second decades(48.3%). In cases of unilateral ptosis, left lid was higher incidence(60%) than right lid and 4 cases(14%) were bilateral ptosis. The amount of ptosis was between 3 and 4mm in most cases(48.5%), and over the 5mm was 12 cases(36.3%). Preoperative levator function between 4 and 7mm of the patient was in 18 cases(54.5%) and 3mm or less was 12 cases(36.3%). Between 16 and 19mm muscle resection was 10 cases(43.5%), Between 12 and 15mm resection was 7 cases(30.4%). In initially corrected visual acuity with Hans Chart. 12 cases(36%) were 0.5-1.0 and 2 cases were 0.1 or less. There is no significant visual improvement after one year surgical correcton. The most common surgical procedure was levator muscle resection(73%) through anterior skin incision and followed by frontalis suspension in 9 cases(27%). The result of operation was good for the period of six months follow-up. The most common complication was undercorrection in 2 cases of levator muscle resection and 1 case of frontalis suspension. The other complications were overcorrectopn, exposure keratitis and entropion in each case, respectively.