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Margin rotation for tarsal buckling following ptosis surgery

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Abstract

Purpose

To assess the clinical characteristics of tarsal buckling after ptosis correction and its management with margin rotation techniques.

Methods

Multicenter retrospective review of ten patients who developed upper eyelid entropion following ptosis correction. In all cases the tarsal deformity was corrected with margin rotational procedures with either a lid crease anterior approach or a traditional posterior approach. Data collection included patient demographics, type of ptosis surgery, and photographic documentation of the affected eyelids.

Results

Entropion occurred after a variety of different ptosis surgery techniques, including frontalis sling, levator advancement and supramaximal levator resection. A horizontal tarsal fold was detected in all eyelids, being in the upper third of the tarsus in 70% and in the central tarsus in 20% of the cases. Tarsal buckling was corrected in all cases with rotational surgery, with nine cases being operated through an anterior lid crease approach and 1, through the traditional posterior approach. The most reported complication was minimal residual ptosis.

Conclusion

Tarsal buckling following ptosis surgery is associated with folds located in the upper part of the tarsus. Margin rotation techniques are effective in restoring the natural position of the eyelid margin in these cases.

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Authors and Affiliations

  1. Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, Hospital das Clínicas de Ribeirão Preto-CAMPUS, University of São Paulo, Av Bandeirantes 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil

    Antonio A. V. Cruz, Juliana A. Guimarães & Roque L. Souza

  2. Department of Ophthalmology, Orbital and Ophthalmic Plastic Surgery, Instituto Hospital de Base Do Distrito Federal, Brasília, DF, Brazil

    Stefania B. Diniz

  3. Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain

    Alicia Galindo-Ferreiro

  4. Hospital de Olhos Francisco Vilar, Teresina, PI, Brazil

    Lilyan M. F. Araujo

  5. Irecê, Bahia, Brazil

    Sheila A. P. Cecchetti

  6. Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo - UNIFESP, Sao Paulo, SP, Brazil

    Ana Estela B. SanťAnna

Authors
  1. Antonio A. V. Cruz
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  2. Stefania B. Diniz
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  3. Juliana A. Guimarães
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  4. Roque L. Souza
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  5. Alicia Galindo-Ferreiro
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  6. Lilyan M. F. Araujo
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  7. Sheila A. P. Cecchetti
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  8. Ana Estela B. SanťAnna
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Contributions

AC and SD contributed to the study conception and design. AC, SD and JG wrote the main manuscript text. RL, AC, SB and JG prepared figures. Data collection was performed by AC, AGF, LA, SC and AES. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Antonio A. V. Cruz.

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The authors have no financial interests or conflicts of interest to disclose.

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The authors declare no competing interests.

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Cruz, A.A.V., Diniz, S.B., Guimarães, J.A. et al. Margin rotation for tarsal buckling following ptosis surgery. Int Ophthalmol 43, 741–748 (2023). https://doi.org/10.1007/s10792-022-02473-5

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  • DOI: https://doi.org/10.1007/s10792-022-02473-5

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