Department of Plastic Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore.
Aesthet Surg J. 2021 Sep 14;41(10):1120-1129. doi: 10.1093/asj/sjab039.
The unique anatomy of the Asian upper eyelid requires specific adaptation to the levator advancement technique for ptosis correction to achieve predictable and reproducible outcomes.
The levator musculo-aponeurotic junction was employed as they key landmark. With a formula developed by the authors, the location of fixation relative to this landmark can be predicted preoperatively. The authors' clinical experience and outcomes with this technique are presented.
Inclusion criteria were Asian patients with mild to severe ptosis with at least fair levator function. Patients with acquired or congenital ptosis and primary and revisional cases were all included. The location for placement of the advancement sutures was measured from the musculo-aponeurotic junction of the upper eyelid levator. This distance was determined by a formula that considers (1) the amount of elevation of the upper eyelid margin needed, (2) the degree of compensatory brow elevation present, and (3) eye dominance.
A total 156 Asian patients were included in this prospective study. Of these, 148 were bilateral and 8 were unilateral corrections. The technique was predictable with resolution of symptoms of eyelid ptosis post-surgery and good long-term symmetry of the palpebral aperture and crisp upper eyelid creases. The formula for estimating the fixation point on the levator was accurate to within ±1 mm in the majority of patients. The aperture revision rate was 2%.
This novel technique provides a predictable and reliable approach for upper eyelid ptosis correction in Asian patients.
亚洲人的上眼睑解剖结构独特，需要对提肌前徙术进行特定的调整，以达到可预测和可重复的效果。
以提肌肌膜结合部为关键标志。作者开发了一个公式，可以在术前预测固定点相对于该标志的位置。本文介绍了作者的临床经验和该技术的结果。
纳入标准为轻度至重度上睑下垂、至少有一定提肌功能的亚洲患者。纳入的患者包括获得性或先天性上睑下垂、原发性和复发性患者。上睑提肌的肌膜结合部作为确定悬吊缝线位置的标志，通过一个公式来测量悬吊缝线的位置，该公式考虑了（1）上睑缘提升的高度，（2）代偿性眉抬高的程度，（3）眼优势。
这项前瞻性研究共纳入 156 例亚洲患者，其中 148 例为双侧，8 例为单侧。该技术具有良好的可预测性，术后上睑下垂症状得到缓解，长期保持睑裂对称和上睑折痕清晰。在大多数患者中，估计提肌固定点的公式的准确性在±1mm 以内。需要进行睑裂修正的比例为 2%。
对于亚洲患者的上睑下垂矫正，这种新的技术提供了一种可预测和可靠的方法。
