Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Director of the International Aesthetic Medical Center, Park One International Hospital, Kaohsiung, Taiwan.
Aesthet Surg J. 2021 May 18;41(6):NP260-NP266. doi: 10.1093/asj/sjaa429.
Severe blepharoptosis with poor levator function (LF) has traditionally been managed with exogenous frontalis suspension but complications such as lagophthalmos, infection, and rejection are often reported.
The aim of this study was to design a function-preserving frontalis orbicularis oculi muscle (FOOM) flap to correct severe blepharoptosis with poor LF. The long-term surgical outcome of the technique was assessed.
This retrospective study included only adult patients with severe blepharoptosis and poor LF, all of whom had their surgery performed by the senior surgeon over a 6-year period. Clinical assessment of LF, palpebral fissure height (PFH), marginal reflex distance 1 (MRD1), duration of follow-up, and postoperative complications were recorded.
A total of 34 patients and 59 eyelids were recorded during a mean follow-up period of 17.7 months. Postoperative evaluation yielded mean [standard deviation] improvements of PFH gain of 5.62 [1.61] mm (P < 0.001), and MRD1 and PFH increases of 4.03 [0.82] mm (P < 0.001) and 8.94 [0.81] mm (P < 0.001), respectively. All patients demonstrated normalization of orbicularis function: no lagophthalmos was observed at the 8-month postoperative follow-up. Recurrence of ptosis was recorded in 4 eyelids (6.78%). Revisions were performed in 2 eyelids (3.39%). No infection or granuloma was noted.
The function-preserving FOOM flap is a useful vector for frontalis suspension. Not only does it effectively address lagophthalmos as well as other complications, but it provides aesthetically pleasing outcomes in patients with severe blepharoptosis and poor LF.
严重的上睑下垂伴提上睑肌功能不良（LF）传统上采用外源性额肌悬吊术治疗，但常出现诸如睑裂闭合不全、感染和排斥等并发症。
本研究旨在设计一种保留功能的额肌眼轮匝肌（FOOM）皮瓣，以矫正严重的上睑下垂伴提上睑肌功能不良。评估该技术的长期手术效果。
本回顾性研究仅纳入 6 年内由资深外科医生为严重上睑下垂伴提上睑肌功能不良的成年患者实施手术的病例。记录 LF、睑裂高度（PFH）、角膜缘反射距离 1（MRD1）、随访时间和术后并发症等临床评估结果。
共记录了 34 例患者的 59 只眼睑，平均随访时间为 17.7 个月。术后评估显示，PFH 平均增加了 5.62 [1.61] mm（P < 0.001），MRD1 和 PFH 分别增加了 4.03 [0.82] mm（P < 0.001）和 8.94 [0.81] mm（P < 0.001）。所有患者的眼轮匝肌功能均恢复正常：术后 8 个月随访时均未出现睑裂闭合不全。4 只眼睑（6.78%）出现上睑下垂复发，2 只眼睑（3.39%）需行修复术。未出现感染或肉芽肿。
保留功能的 FOOM 皮瓣是一种有效的额肌悬吊术向量。它不仅能有效解决睑裂闭合不全等并发症，还能为严重上睑下垂伴提上睑肌功能不良患者提供美观的效果。
