Pre-Whitnall Levator Recession With Hang-Back Sutures in Graves Orbitopathy
| Autor: | J. E. K. Galbraith, Ric Caesar, Alan A McNab, Justin Friebel |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Eye Diseases Ophthalmologic Surgical Procedures Postoperative Complications Ptosis medicine Humans Aged Ligaments business.industry Suture Techniques Postoperative complication General Medicine Middle Aged Graves Disease eye diseases Single surgeon Surgery body regions Ophthalmology Oculomotor Muscle medicine.anatomical_structure Oculomotor Muscles Ligament Female sense organs Eyelid medicine.symptom business Orbit Ophthalmologic Surgical Procedure Orbit (anatomy) |
| Zdroj: | Ophthalmic Plastic & Reconstructive Surgery. 20:301-307 |
| ISSN: | 0740-9303 |
| Popis: | PURPOSE: To describe a technique for lengthening the levator palpebrae muscle at the level of the transverse orbital ligament (Whitnall ligament) by using hang-back sutures in cases of upper eyelid retraction in Graves orbitopathy, and to report its results. METHODS: A cohort of consecutive patients undergoing this procedure by a single surgeon was analyzed. The surgical technique involved division of the levator muscle high up, at the level of the transverse orbital ligament, with lengthening of the muscle by a graded amount with the use of nonabsorbable hang-back sutures. The length of the sutures was twice the amount of desired lowering of the eyelid. RESULTS: Surgery was performed on 38 eyelids of 21 patients. The mean preoperative eyelid retraction was 4.7 mm (range, 3 mm to 8 mm). Thirty-two eyelids (84%) were within 1 mm of the desired postoperative position. One patient required reoperation for significant undercorrection (2 eyelids), another 4 had ptosis repairs for overcorrection (5 eyelids, one of which was only 1-mm overcorrected). One eyelid required medial contour repair, but none needed lateral contour correction. CONCLUSIONS: This procedure gives a relatively predictable result in patients with moderate to severe upper eyelid retraction and avoids the postoperative complication of contour deformities, especially lateral flare. |
| Databáze: | OpenAIRE |
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