Cesneková T, Jurecka T, Skorkovská K, Tesarová M, Hanisková H, Wenchich L, Zámecník J, Zeman J
Klinika nemocí ocních a optometrie LF MU, Fakultní nemocnice u svaté. Anny, Brno.
Cesk Slov Oftalmol. 2011 Oct;67(4):133-5.
The aim is to report a rare complication of surgical ptosis correction in a patient with Kearns Sayre syndrome and the therapeutic possibilities of its treatment.
Exposure corneal ulceration caused by lagophtalmos developed gradually in a 30-year-old woman after an upper eyelid ptosis surgery of the right eye performed at another eye clinic. During an examination a limited movement of both eyes and retinal pigmentary changes (salt-pepper-like appearance) were diagnosed. A suspicion of the Kearns Sayre syndrome was expressed according to the clinical picture, the diagnosis was confirmed by molecular analyses in muscle biopsy, which revealed 5.2 kb deletion of mitochondrial DNA.
Corneal ulceration was treated by partial external tarsorrhaphy and frequent instillation of lubricants. The upper eyelid ptosis of the left eye was treated with a spectacle with ptosis support.
During the correction of upper eyelid ptosis in patients with progressive external ophtalmoplegia it is necessary to be aware of the risk of surgical exposure keratopathy and corneal ulceration due to the atony of musculus orbicularis oculi muscle and only slightly expressed Bell's phenomenon.
