Pang Runhui, Liu Zhaochuan, Wang Huixing, Wang Juan, Shi Junhu, Xiao Li, Bai Ping
Department of Ocular Plastics, Hebei Eye Hospital, Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Hebei Eye Hospital, Xingtai, Hebei, China.
Department of Ophthalmology, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China.
Medicine (Baltimore). 2025 Feb 28;104(9):e41624. doi: 10.1097/MD.0000000000041624.
Blepharoptosis is a common disorder characterized by abnormal eyelid position that affects both visual function and esthetics. Postoperative upper eyelid retraction, which is often due to overcorrection, is a major problem. Under normal circumstances, the operation is usually performed on the overcorrected eye. Here, we present the case of a patient who had previously undergone surgery to correct right upper blepharoplasty, which resulted in asymmetry. Utilizing Hering's law, we decided to correct only the left eye, resulting in remarkable bilateral symmetry after surgery. This proves that for patients with ptosis after upper eyelid surgery, a comprehensive approach should be considered rather than just one treatment method.
Here, we report a case of overcorrection of ptosis in a male patient who underwent corrective surgery.
Based on the patient's ocular examination, appearance, medical history, measurement of levator muscle strength, and MRD1 measurement, the diagnosis was postoperative overcorrection of ptosis of the right upper eyelid.
In this case, preoperative examination revealed a reduction in the size of the right eye when the left eyelid was lifted, which was in accordance with Hering's law. Consequently, surgical intervention was limited to the left eye, resulting in excellent bilateral symmetry after surgery.
The surgery was successful and resulted in symmetry between both eyes. We followed up with the patient for a year and he was extremely satisfied with the surgical results. The outpatient follow-up revealed no discomfort.
Postoperative upper eyelid retraction following monocular ptosis correction is a rare condition. The conventional treatment approach typically involves reoperation on the affected eye. However, considering the importance of Hering's law in the management of ptosis, excellent outcomes were achieved in this case through surgery on the contralateral, unaffected eye. When treating a patient, the operation should be tailored to their specific condition.
上睑下垂是一种常见疾病，其特征为眼睑位置异常，会影响视觉功能和美观。术后上睑退缩通常是由于矫正过度导致的，这是一个主要问题。在正常情况下，手术通常针对矫正过度的眼睛进行。在此，我们介绍一例患者，该患者之前接受了右眼上睑成形术矫正手术，但导致了不对称。利用赫林定律，我们决定仅矫正左眼，术后获得了显著的双侧对称性。这证明对于上睑手术后出现上睑下垂的患者，应考虑采用综合方法，而非单一的治疗方法。
在此，我们报告一例接受矫正手术的男性患者上睑下垂矫正过度的病例。
根据患者的眼部检查、外观、病史、提上睑肌力量测量以及MRD1测量，诊断为右眼上睑下垂术后矫正过度。
在该病例中，术前检查发现提起左眼睑时右眼尺寸减小，这符合赫林定律。因此，手术干预仅限于左眼，术后获得了极佳的双侧对称性。
手术成功，双眼实现了对称。我们对患者进行了一年的随访，他对手术结果非常满意。门诊随访显示无不适。
单眼上睑下垂矫正术后的上睑退缩是一种罕见情况。传统的治疗方法通常是对患眼再次手术。然而，考虑到赫林定律在处理上睑下垂中的重要性，通过对健侧未受影响的眼睛进行手术，本病例取得了良好的效果。治疗患者时，手术应根据其具体情况进行调整。
