2016-38: Acquired aponeurogenic blepharoptosis: efficacy of a modified Fasanella Servat procedure (tarsoconjunctival mullerectomy) in a tertiary centre.
Aponeurogenic blepharoptosis is the most common type of acquired blepharoptosis. The most frequent cause is involutional desinsertion or ‘thinning’ of the levator aponeurosis. In the younger and middle aged, known risk factors for aponeurogenic ptosis are the use of hard- and soft contactlenses, previous eye surgery or dry eye.
Aponeurogenic blepharoptosis is characterized by a slow-progressive development of eyelid ptosis, a good levator function and a high eyelid crease. The surgical treatment of this condition is based on the reattachment of the levator aponeurosis to the tarsal plate, as in the anterior levator reinsertion. Alternatively, a posterior approach can be used in mild cases of aponeurogenic or neurogenic blepharoptosis. It consists of the resection of tarsus, conjunctiva and Müller´s muscle, also called tarsoconjunctival mullerectomy (TCM) or resection of Muller’s muscle (Mullerectomy). Recently, posterior approaches have gained popularity among oculoplastic surgeons for the management of patients with moderate degrees of blepharoptosis.
Objective of this study is to evaluate the efficacy of TCM for the correction of acquired aponeurogenic blepharoptosis.