1. Levator tendon plication correction

1. Tag: surgery

2. Technical principle

This surgery is The aponeurosis of the levator palpebrae superioris is incised and separated using surgical methods. The aponeurosis is folded and sutured according to the height to which the levator palpebrae superioris muscle needs to be lifted to achieve the purpose of correcting ptosis.

3. Applicable groups and taboo groups

1) Applicable groups: Suitable for mild ptosis or good muscle strength, and the folding length is generally controlled within 10mm.

2) Contraindications

② People with infectious diseases or other body inflammations who cannot undergo ptosis correction.

③ People with scarred constitution.

④ Women during menstruation or pregnancy.

⑤ Mental patients or people with various mental disorders, as well as those with strong opposition from their families.

4. Cost: 2000-8000 yuan

5. Technical method

① Incision design: draw an incision line 6-7mm away from the upper eyelid margin .

② Anesthesia: Local infiltration anesthesia for adults, inhalation anesthesia with endotracheal intubation for children.

③ Incision: According to the designed incision, separate and remove part of the pretarsal orbicularis oculi muscle and connective tissue to expose the upper edge of the tarsal plate.

④ Separation and cutting: The retractor pulls the skin upward to separate the levator palpebrae superioris aponeurosis; decide whether to longitudinally cut the medial and lateral legs of the levator palpebrae superioris tendon based on the length of separation required.

⑤ Fold the absorbable suture to suture the aponeurosis.

⑥ Knotting and fixing: Lift the upper eyelid to a satisfactory height and tie it with a knot.

⑦ Suture the skin and apply pressure bandage.

6. Risks and complications

① Insufficient correction: caused by insufficient folding and shortening of the levator palpebrae superioris muscle or excessive loose suture ligation; it may occur 3-6 months after surgery Corrective surgery will be performed in a month.

③ Exposure keratitis: In order to prevent the occurrence of complications, you can follow the doctor's advice and apply artificial tears during the day regularly within 2 months after the operation, and apply eye ointment before going to bed at night. In severe cases, you should seek medical help immediately .

⑤ The curvature of the eyelid margin is not ideal: contact the doctor as soon as possible after discovery.

⑥ Supraorbital neuralgia: Generally, no special treatment is required, and painkillers and vitamin B1 can also be taken for symptomatic treatment.

⑦ Infection: Once infection occurs, you should go to the hospital for further examination immediately.

7. Treatment course and recovery time

Eye drops will be instilled every day after the operation, the pressure bandage will be removed and the dressing will be changed 48 hours later, and the sutures will be removed 5-7 days after the operation.

8. Precautions

1) Preoperative Precautions

③ Before surgery, make sure you are in good health and have no infectious diseases or other body inflammations;

④ Do not wear makeup before surgery;

⑤ Women should avoid menstrual period.

2) Precautions after surgery

② Try to avoid getting the surgical site wet within 7 days after surgery;

③ Ensure the surgical site is clean;

④ Strictly abide by the doctor’s instructions for taking medication and follow-up visits.

2. Levator muscle shortening correction surgery

1. Tag: surgery

2. Technical principle

This method is through The surgical incision separates the tissues around the eyelids and cuts off the levator palpebrae superioris muscle to shorten the length of the levator palpebrae superioris muscle and correct ptosis.

3. Applicable and contraindication groups

1) Applicable group: Suitable for those with recurrent mild or congenital moderate ptosis with muscle strength of 5-8mm , also used for patients with mild blepharoptosis who have poor results from intraoperative levator plication.

2) Contraindications

① People with bleeding tendencies and hypertension, as well as active and progressive diseases of important organs such as heart, lungs, liver, and kidneys.

② People with infectious diseases or other body inflammations who cannot correct ptosis.

③ People with scarred constitution.

④ Women during menstruation or pregnancy.

⑤ Mental patients or people with various mental disorders, as well as those with strong opposition from their families.

4. Cost: 2000-8000 yuan

5. Technical method

① Incision design: draw a line at the fold 5-6mm away from the upper eyelid margin.

② Anesthesia: Local infiltration anesthesia for adults, inhalation anesthesia with endotracheal intubation for children.

③ Incision: Incise the skin along the mark, separate and remove part of the pretarsal orbicularis oculi muscle, connective tissue and tarsal plate, and expose the controlling ligament.

④ Make a vertical incision inside and outside the levator aponeurosis on the upper edge of the tarsus to separate the levator muscle and fornix conjunctiva.

⑤ Shorten the levator palpebrae superioris muscle: Cut off the levator palpebrae superioris muscle at the upper edge of the tarsal plate. Generally, for every 1mm of ptosis corrected, the levator muscle must be shortened by more than 4-6mm.

⑥ Fix the shortened levator palpebrae superioris muscle to the tarsus with sutures.

⑦ Suture the skin and bandage it with pressure.

6. Risks and complications

① Insufficient correction: caused by insufficient shortening of the levator palpebrae superioris muscle or excessive loose suture ligation; it may occur 3-6 months after surgery Corrective surgery is performed again.

⑤ Conjunctival perforation: Those with larger perforations may be at risk of granulation tissue hyperplasia and blepharopharosis.

⑦ Infection: Once infection occurs, you should go to the hospital for further examination immediately.

7. Treatment course and recovery time

The pressure bandage will be removed and the dressing will be changed 48 hours after the operation, and the sutures will be removed 5-7 days after the operation.

8. Precautions

1) Preoperative Precautions

① Do not take drugs containing aspirin within two weeks before surgery. Aspirin It will reduce the coagulation function of platelets;

② Patients with hypertension and diabetes should fully inform their doctors about their condition during the initial diagnosis so that the attending doctor can confirm the surgical plan;

③ Surgery Make sure you are in good health and have no infectious diseases or other body inflammations before surgery;

④ Do not wear makeup before surgery;

⑤ Women should avoid menstrual period.

2) Precautions after surgery

① Within 3-5 days after surgery, avoid some irritating foods, such as peppers, raw onions, raw garlic, ginger and seafood, etc. It should be prohibited to eat;

② Try to avoid getting water on the surgical site within 7 days after surgery;

③ Make sure the surgical site is clean;

④ Strictly follow the doctor’s instructions Take medication and follow-up visits.

3. Ptosis suspension correction surgery

1. Frontalis myofascial flap suspension surgery

1) Tag: surgery

Surgical method is used to cut off the frontalis muscle, separate the frontal fascia flap, and fix the frontalis fascia flap to the upper edge of the tarsal plate through suspension, so that the drooping upper eyelids can be corrected .

3) Applicable groups and taboo groups

① Applicable groups: Suitable for moderate and severe ptosis, especially those with levator eyelid muscle movement of less than 4mm and ptosis of more than 4mm. Those with severe ptosis; those with frontal muscle activity above 10mm.

② Taboo groups

c. People with scars.

d. Women during menstruation or pregnancy.

e. Mental patients or people with various mental disorders, as well as those with strong opposition from their families.

4) Cost: 2000-8000 yuan

5) Technical methods

① Anesthesia: local infiltration anesthesia for adults, inhalation anesthesia with endotracheal intubation for children .

② Incision: Incise the skin, orbicularis oculi muscle to the lower layer, and reach the tarsal plate of the upper eyelid.

③ Separation and cutting: separate the orbital septum and the orbicularis oculi muscle and frontalis muscle aponeurosis in front of the orbital septum, and cut off the frontalis muscle transversely.

④ Suture and fix the frontalis fascial flap to the upper edge of the tarsal plate.

⑤ Stop bleeding.

⑥ Suture the skin.

⑦ Local pressure bandaging.

6) Risks and complications

① Insufficient correction: caused by loose sutures and insufficient frontalis muscle suspension height. It may occur 3-6 months after surgery Corrective surgery is performed again.

② Overcorrection: caused by excessive resection of the frontalis muscle or excessive suspension of the frontalis muscle. Mild cases generally do not require treatment and can generally be relieved after 2 weeks. In severe cases, the fixing sutures must be removed as soon as possible, the upper eyelids must be massaged downwards, or surgery must be performed again.

③ Exposure keratitis: In order to prevent the occurrence of complications, follow the doctor's advice and apply artificial tears during the day regularly within 2 months after the operation, and apply eye ointment before going to bed at night. In severe cases, seek medical help immediately.

④ Supraorbital neuralgia: Generally, no special treatment is required, and painkillers and vitamin B1 can also be taken for symptomatic treatment.

⑤ Conjunctival perforation: Those with larger perforations may be at risk of granulation tissue hyperplasia and blepharopharosis.

⑥ Entropion of the eyelids: It can be caused by improper fixation point after correction; you should keep in touch with the doctor in time to detect and treat it as early as possible.

⑦ Infection: Once infection occurs, you should go to the hospital immediately for further examination.

7) Treatment course and recovery time

The pressure bandage will be removed and the dressing will be changed 48 hours after the operation, and the sutures will be removed 5-7 days after the operation.

8) Precautions

① Preoperative Precautions

a. Do not take drugs containing aspirin within two weeks before surgery. Aspirin It will reduce the coagulation function of platelets;

b. Patients with high blood pressure and diabetes should fully inform their doctors about their condition during the initial diagnosis so that the attending doctor can confirm the surgical plan;

c . Make sure you are in good health before surgery and have no infectious diseases or other body inflammation;

d. Do not wear makeup before surgery;

e. Women should avoid menstrual period.

② Precautions after surgery

a. Within 3-5 days after surgery, avoid some irritating foods, such as peppers, raw onions, raw garlic, ginger and seafood. It should be prohibited to eat;

b. Try to avoid getting water on the surgical site within 7 days after surgery;

c. Make sure the surgical site is clean;

d. Strictly Follow the doctor’s instructions on taking medications and follow-up visits.

2. Forehead Suspension

1) Tag: Surgery

2) Technical Principle

Surgery is used to lift the forehead The skin and deep tissues are incised and separated, and the suspension material is sutured and fixed with the frontalis muscle to lift the upper eyelid and correct ptosis. As the intermediary suspension material, PTFE, silk thread, metal wire, or autologous materials such as fascia lata, orbicularis oculi muscle bundle, and dermis can be selected.

3) Applicable groups and contraindication groups

① Applicable groups: Suitable for severe ptosis with levator muscle strength <4mm and ptosis of more than 4mm, but for patients with severe ptosis. Patients with myasthenia gravis, peripheral facial paralysis, and loss of frontalis muscle function cannot use this method.

② Contraindications

a. People with bleeding tendencies and hypertension, as well as active and progressive diseases of important organs such as the heart, lungs, liver, and kidneys.

b. People who have infectious diseases or other body inflammations and cannot undergo ptosis correction.

c. People with scars.

d. Women during menstruation or pregnancy.

e. Mental patients or people with various mental disorders, as well as those with strong opposition from their families.

4) Cost: 2000-8000 yuan

5) Technical method

① Preoperative design: Draw a line at the fold 6-7mm away from the eyelid margin.

② Anesthesia: Local infiltration anesthesia for adults and general anesthesia for children.

③ Incision: Incise the skin of the upper eyelid and the upper edge of the eyebrow to the surface of the frontalis muscle; remove part of the orbicularis oculi muscle to expose the tarsal plate.

④ Make an incision about 0.5cm long at the middle of the pupil and the inner and outer canthus at the upper edge of the eyebrow, separate the orbicularis oculi tarsus and reach the frontalis muscle.

⑤ Insert the suspension material, place one end of the suspension material on the central incision on the eyebrow, connect the other end to the lateral canthus incision on the upper edge of the eyebrow, and fix it at the junction of the middle and outer 1/3 of the tarsal plate. at.

⑥ Adjust the height of the eye fissure and the curvature of the eyelid margin that need to be lifted, and fix it on the frontalis muscle.

⑦ Suture the skin.

⑧ Local pressure bandaging.

6) Risks and complications

① Insufficient correction: improper selection of surgical procedures and excessively loose suture ligation. Intraoperative findings should be corrected immediately, or corrective surgery should be performed 3-6 months after surgery.

③ Exposure keratitis: In order to prevent the occurrence of complications, artificial tears should be applied regularly during the day within 2 months after surgery, and eye ointment should be applied before going to bed at night. In severe cases, seek medical help immediately.

⑤ Conjunctival perforation.

⑥ Entropion of eyelids.

⑦ Infection: Once infection occurs, you should go to the hospital immediately for further examination.

7) Treatment course and recovery time

The dressing and dressing will be changed 1 day after surgery, and the dressing and sutures will be removed 7 days after surgery.

8) Precautions

① Preoperative Precautions

c. Before surgery, make sure you are in good health and have no infectious diseases or other body inflammations;

d. Do not wear makeup before surgery;

e. Women should avoid menstrual period.

② Postoperative precautions

b. Try to avoid getting the surgical site wet within 7 days after the operation;

c. Ensure the surgical site is clean;

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d. Strictly abide by the doctor’s instructions for taking medication and follow-up visits.