What's new AAPOS 2008 - The Private Eye Clinic

Superior oblique tendon damage resulting from eyelid surgery.
Kushner BJ, Jethani JN.
Am J Ophthalmol. 2007 Dec;144(6):943-948. Epub 2007 Oct 22.
PURPOSE: To describe the occurrence of superior oblique (SO) tendon damage
resulting from upper eyelid surgery and to explain its cause and treatment. DESIGN:
Retrospective, observational case series.
METHODS: An institution-based retrospective observational case series of seven
patients in whom damage to the SO tendon secondary to eyelid surgery developed.
RESULTS: In four of the patients, ipsilateral SO palsy developed, and three patients, a
Brown syndrome pattern developed. The causative eyelid procedures consisted of
surgery to correct ptosis in four patients, tumor removal in two patients, and cosmetic
blepharoplasty in one patient.
CONCLUSIONS: The SO tendon may be damaged as a result of eyelid surgery. The
anatomy of the SO tendon should be kept in mind while performing surgery in the
superomedial aspect of the upper eyelid.
LASH PTOSIS IN CONGENITAL AND ACQUIRED BLEPHAROPTOSIS
Khurram J Malik MD; Michael S Lee MD; D J John Park MD; Andrew R Harrison MD
Arch Ophthalmol 2007;125(12):1613-1615
The objective of this study was to determine the prevalence of lash ptosis (LP) in eyes
with congenital and acquired blepharoptosis. Photographs of 228 eyes from 174
patients with congenital or acquired blepharoptosis were retrospectively graded for LP.
The authors used a 4-point rating scale for LP, in which 0 indicates no LP; 1, minimal; 2,
moderate; and 3, severe. A prospective evaluation of LP in 30 eyes from 15 patients
without blepharoptosis (control eyes) was also performed.
A total of 107 eyes (in 87 patients) demonstrated congenital blepharoptosis and 121
eyes (in 87 patients) had acquired blepharoptosis. A moderate to severe rating of LP
(rating, ≥ 2) occurred in 60.7% of eyes with congenital blepharoptosis, 28.9% of eyes
with acquired blepharoptosis, and 6.7% of control eyes. Lash ptosis (rating, ≥ 1) was
present in 91.6% of eyes with congenital blepharoptosis, 83.5% of eyes with acquired
blepharoptosis, and 33.3% of control eyes. The mean LP rating was 2.1 for eyes with
congenital blepharoptosis, 1.3 for eyes with acquired blepharoptosis, and 0.6 for control
eyes.
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