Abstract

Volume.123 Number.6

Original article : Clinical science

Transconjunctival Levator Aponeurotic Tucking for Aponeurotic Blepharoptosis
Hiromichi Matsuda1, Tsutomu Sakai1, Tadashi Nakano2
1 Department of Ophthalmology, Daisan Hospital, The Jikei University School of Medicine
2 Department of Ophthalmology, The Jikei University School of Medicine

Purpose: To examine the surgical outcome and complications of a transconjunctival levator aponeurotic tucking procedure for aponeurotic blepharoptosis.
Methods: This retrospective study included 109 eyelids from 60 patients with aponeurotic blepharoptosis who had undergone transconjunctival levator aponeurotic tucking between January 2017 and March 2018. The procedure involved a conjunctival incision 2 mm above the upper edge of the tarsus. After dissecting Müller muscle bluntly from the levator aponeurosis, the posterior surface of the levator aponeurosis was tucked and subsequently sutured and fixed to the anterior surface of the tarsus. At the last follow-up visit, the surgery was considered a success only if all the following criteria were simultaneously met: margin reflex distance (MRD) was between 2 and 4.5 mm, an asymmetry in MRD was ≤1 mm, and a natural symmetrical eyelid contour was present.
Results: Successful results were obtained in 54 patients (90.0%). Recurrence (<2 mm in MRD) was observed in 5 patients (8.3%). A postoperative complication, corneal epithelial defect owing to ablation by the long thread of the knot in two patients, was improved by trimming the thread in both patients. After the surgery, none of the patients experienced worsening of their dry eye.
Conclusion: Transconjunctival levator aponeurotic tucking is a safe and effective procedure for aponeurotic blepharoptosis.

Key words
Transconjunctival, Levator aponeurosis, Tucking, Aponeurotic blepharoptosis
Reprint requests to
Hiromichi Matsuda, M.D. Department of Ophthalmology, Daisan Hospital, The Jikei University School of Medicine. 4-11-1 Izumihon-cho, Komae-shi, Tokyo 201-8601, Japan