• Archives of Plastic Surgery
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• v.41 no.1
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• pp.71-76
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• 2014

Background Numerous methods exist for simultaneous correction of mild blepharoptosis during double eyelid surgery. These methods are generally categorized into either incisional (open) or non-incisional (suture) methods. The incisional method is commonly used for the creation of the double eyelid crease in patients with excessive or thick skin. However, concurrent open ptosis correction is often marred by the lengthy period of intraoperative adjustment, causing more swelling, a longer recovery time, and an increased risk of postoperative complications. Methods The authors have devised a new, minimally invasive technique to alleviate mild ptosis during incisional double eyelid surgery. The anterior lamella is approached through the incisional technique for the creation of a double eyelid while the posterior lamella, including Muller's and levator muscles, is approached with the suture method for Muller's plication and ptosis correction. Results The procedure described was utilized in 28 patients from June 2012 to August 2012. Postoperative asymmetry was noted in one patient who had severe preoperative conjunctival scarring. Otherwise, ptosis was corrected as planned in the rest of the cases and all of the patients were satisfied with their postoperative appearance and experienced no complications. Conclusions Our hybrid technique combines the benefits of both the incisional and suture methods, allowing for a predictable and easily reproducible correction of blepharoptosis with an aesthetically pleasing double eyelid.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.17 no.2
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• pp.165-169
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• 2004

Objective: The purpose of this case study is to show a case of severe neurogenic ptosis due to midbrain infarction improved by acupuncture and Herb-med. Method: This case study has been carried out for a case of ptosis due to midbrain infarction which had been hospitalized at the Bundang CHA Oriental Medical Hospital. We evaluate through Levator function test and measurement of MRD and the distance between upper and lower eyelid. Results: Levator function increase 3.5mm and distance between upper and lower eyelid increase 4mm more than before. The degree of ptosis turned 'fair' state from 'poor' state. Conclusions: We suggest to treat ptosis due to midbrain infarction with acupuncture and Herb-med meaning conservative therapy and would like to research oriental medical treatment plan for the further treatment.

• Journal of Acupuncture Research
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• v.27 no.4
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• pp.233-238
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• 2010

Objectives : This study is designed to find out the improvement of eyelid ptosis and eyeball movement trouble caused by idiopathic oculomotor nerve palsy after diagnosing the patient to Ghan-shil (肝實), Bee, Shin-hur(脾腎虛) and treating the patient with acupuncture and herb medicine. Methods & Results : The changes in clinical symptoms of eyelid ptosis and eyeball movement trouble were described as the patient was treated with acupuncture therapy and herb medicine, Shae-ghan-san gagam(洗肝散加減) and Yukmi-jihwang-tang gagam(六味地黃湯加減). Conclusions : The patient was treated by acupuncture, herb medicine on idiopathic oculomotor nerve palsy for 6 weeks and showed good effect.

• Archives of Plastic Surgery
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• v.33 no.4
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• pp.449-453
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• 2006

Purpose: Perceiving the experience that $MRD_1$ is increased after small-incision double-eyelid operation, it has been statistically verified the improvement of $MRD_1$ retrospectively. Therefore, we suggest new interpretation for Korean-specific small eye and more definite classification for ptosis. Methods: In operation, we made 3 small incisions according to the line designed on upper eyelid and removed some soft tissues including connective tissues. Then, figure-of-8 continuous buried ligation was performed through the incision windows. This study is a retrospective study, measures $MRD_1$ changes and excursion distance change of eyelid margine and eyebrow using pre-and post-operative photos of 14 patients. Results: Postoperative photos were taken on the 4th day and all of 14 patients had an improvement in $MRD_1$ statistically. The excursion distance of upper eyelid was improved in half of patients, though not in the range of statistical verification. It was statistically confirmed that the movement of eyebrow was reduced after operation. Conclusion: It is thought that $MRD_1$ improvement without any operation on levator complex means that soft tissue including connective tissue eliminated in operation restricts the movement of upper eyelid. It is defined such factors as burden factors and such phenomenon as burdened eyelid. It is thougt that Korean's small eye is mainly burdened eyelid and cosmetic improvement may be obtaind even by removing such burden factors.

• Archives of Plastic Surgery
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• v.47 no.4
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• pp.290-296
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• 2020

In many aging individuals, dermatochalasis and involutional ptosis appear together. Therefore, for functional and aesthetic purposes, ptosis correction and upper blepharoplasty are performed together. The aim of this article is to investigate factors that should be considered in order to achieve good results when simultaneously performing involutional ptosis correction and upper blepharoplasty in aging patients. Involutional ptosis is usually corrected through aponeurosis advancement in mild cases. In moderate or severe ptosis, the Muller muscle and aponeurosis are used together to correct ptosis. Using the two muscles together has the advantages of reducing lagophthalmos and increasing the predictability of outcomes after surgery. Broadly speaking, the surgical method used for involutional ptosis varies depending on the specific case, but unlike congenital ptosis, it is often not necessary to perform overcorrection. In particular, if there are problems such as severe dry-eye symptoms or risk of lagophthalmos, undercorrection should be considered. When performing ptosis correction, the surgeon should be careful not to overdo skin excision; instead, limited excision should be performed. After ptosis surgery, the brow may descend and the double fold may look too small. However, in order to make the double eyelids look larger, the surgeon should consider making the double eyelid design high rather than excising an excessive amount of skin. In some cases, to obtain more natural double eyelids and favorable results, it may be necessary to perform a sub-brow lift or forehead lift before or after involutional ptosis surgery.

• Journal of Haehwa Medicine
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• v.23 no.2
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• pp.45-52
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• 2015

Object : This study is designed to confirm the effect of Traditional korean Medicine on oculomotor nerve palsy patient. Method : We treated with acupuncture therapy, electro-acupuncture therapy, herbal therapy, physical therapy, moxibustion therapy. And we evaluated a patient's eyelid ptosis, eyelid levator function, eyeball movement, eyeball pain. Result : After Traditional korean Medical treatment, ptosis and pain caused by ophthalmoplegia were improved. Conclusion : This study shows Traditional korean Medicine has a good effect on oculomotor nerve palsy.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.3
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• pp.699-702
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• 2008

Oculomotor nerve palsy is a disorder which causes eyeball movement trouble, dipleopia, dizziness and eyelid ptosis. It is caused by aneurysm, mass, truma, intracranial hypertension, diabetes mellitus, infection and so on. But sometimes we can't establish the cause. We report a case of oculomotor nerve palsy associated with spleen energy(脾氣). We treated a patient with herb medicine and acupuncture. This study suggests that oriental medicine theraphy has a good effect on the oculomotor nerve palsy.

• Archives of Plastic Surgery
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• v.32 no.2
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• pp.219-226
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• 2005

Muller's muscle-levator aponeurosis advancement procedure was performed to correct mild to moderate congenital blepharoptosis with moderate to good levator function and to correct severe aquired blepharoptosis with poor levator function. Through the blepharoplasty incision, the upper half of the tarsal plate was exposed and the orbital septum was opened to show the levator aponeurosis. The Muller's muscle was dissected from the superior margin of the tarsal plate and from the posteriorly located conjunctiva with sharp scissors. The Muller's muscle and levator aponeurosis were advanced on the anterior surface of the tarsal plate as a composite flap and fixed approximately 3 to 4 mm inferior to the upper edge of the tarsal plate with three horizontal 6-0 nylon mattress sutures. The amount of advancement of the composite flap was controlled by the location of the upper eyelid margin 2 mm below the upper limbus in primary gaze after the first suture in the middle portion of the flap. The excess flap was trimmed off with scissors, but trimming was usually not necessary in cases of mild to moderate ptosis. Nine cases underwent this Muller's muscle-levator aponeurosis advancement procedure from September 2003 to September 2004. Five cases were congenital blepharoptosis with 2-4 mm ptosis and more than 5 mm of levator function, but three of the four acquired ptosis cases had more than 4 mm ptosis with poor levator function. The age of the patients ranged from 7 to 81 years. In operative results, all patients except one traumatic case were within 1 mm of the desired eyelid height in primary gaze. This procedure can provide not only tightening of the Muller's muscle but also advancement and firm fixation of the levator aponeurosis to the tarsal plate, yielding predictable results.

• Archives of Craniofacial Surgery
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• v.20 no.1
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• pp.3-9
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• 2019

Facial nerve palsy has an effect on a person's well-being functionally and psychologically. Therefore, comprehensive patient management is essential. One of the most common uncomfortable and potentially debilitating features is associated with the incapacity for eye closure. Restoration of eye closure is a key consideration during the surgical management of facial palsy. In this article, we introduce simple surgical methods-which are relatively easy to learn and involve the upper and lower eyelids-for achieving eye closure. Correcting upper eyelid function involves facilitating the component of eye closure that is in the same direction as gravity and is, therefore, less complicated and favorable outcomes than correction of lower lid. Aesthetic aspects should be considered to correct the asymmetry caused by facial palsy. Lower eyelid function involves a force that opposes gravity for eye closure, which makes correction of lower eyelid ectropion more challenging than surgery for the upper eyelid, particularly in terms of effecting a sustained correction. Initially, proper ophthalmic evaluation is required, including identifying the chronicity and severity of ectropion. Also, it is important to determine whether or not lateral canthoplasty is necessary. The lateral tarsal strip procedure is commonly used for lower lid correction. However, effective lower lid correction can be achieved with better cosmesis when extensive supporting techniques are applied, including those involving cheek tissue.

• Archives of Plastic Surgery
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• v.42 no.2
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• pp.214-217
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• 2015

Blepharoptosis is a common indication for surgery in plastic surgery units, yet its possible underlying pathology frequently remains unidentified. A 52-year-old man with a 20-year history of progressive bilateral ptosis (right>left) presented with recurrent ptosis of both eyes; he had undergone an operation on the levator aponeurosis 12 years prior. Due to the suspicion of an underlying disease, he was evaluated further. Chronic progressive external ophthalmoplegia in transition to the more severe syndromic variant Kearns-Sayre syndrome, a mitochondrial disorder causing myopathy, was diagnosed. The patient was treated with coenzyme Q10, and he underwent ptosis surgery on both eyes. This case illustrates a potentially multi-systemic disease that was diagnosed by a further evaluation of a common symptom, in this case worsening blepharoptosis. Awareness of myopathic symptoms is necessary to prevent overlooking serious yet improvable conditions.