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Single-triangle technique for congenital ptosis repair with a frontalis sling in blepharophimosis patients

1 Department of Ophthalmology, V. M. M. C and Safdarjung Hospital, New Delhi, India
2 Department of Ophthalmology, H. I. M. S. R and H. A. H. Centenary Hospital, New Delhi, India
3 Mayo Clinic, Rochester, MN, USA

Correspondence Address:
Mayuresh Naik,
Department of Ophthalmology, Room No. 3 of Eye OPD, 1st Floor of OPD Building, H.I.M.S.R and H.A.H.Centenary Hospital, Near GK-2, Alaknanda, New Delhi - 110 062
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjo.tjo_6_21

The purpose of this study was to describe the single-triangle technique for congenital ptosis repair with a frontalis sling in blepharophimosis patients. The single-triangle technique was used in 40 eyes of 20 patients of blepharophimosis syndrome. The center point of the lid is marked. The desired base length is calculated depending on the available horizontal fissure width. Two marks are inked 2 mm above the lid margin, equidistant from the central mark. A single brow mark is placed in such a way that it is directly above the center point of the lid. These are now joined to complete the triangle. In blepharophimosis patients, the mean preoperative margin reflex distance (MRD1) was 1.0 ± 1.1 mm which increased to 4.1 ± 1.6 mm after surgery. The MRD1 increased by 3.1 ± 1.7 mm. Cosmetic outcome was graded with a score of 0, 1, or 2 to indicate poor, good, and excellent results, respectively. Out of the 40 eyes that were operated, 33 eyes had a score of 2, 5 eyes had a score of 1, and 2 eyes were scored 0. The single-triangle technique has several advantages over both the Fox pentagon technique and modified Crawford technique in severe blepharophimosis patients. It is not only a much simpler procedure to perform but also has a better control over the curvature of the lid without any central focal notching, thus providing better cosmesis and esthetic results.

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