[Tarsal switch levator for mitochondrial myogenic ptosis].
OBJECTIVE
To report the use of tarsal switch levator resection procedures that lift the palpebral fissure to visual axis without causing corneal complications in patients with mitochondrial myogenic ptosis.


METHODS
Prospective study. The technique consists of an upper eyelid tarsectomy, with transfer of the autologous tarsoconjunctival graft to the posterior lamella of the lower eyelid. The surgeries were performed under local anesthesia. In case of diplopia, the surgery was performed in one eye.


RESULTS
Tarsal switch procedure was performed in 9 eyes of 6 patients with mitochondrial myopathy. There were 5 women; the average age was 59.8 years and the follow-up ranged from 30 to 60 months. The palpebral fissure was moved cephalad in all patients, unmasking their visual axis in primary position and improving their head position. There was no patient with exposure symptoms after surgery.


CONCLUSIONS
The tarsal switch procedure is useful in managing the eyelid malpositions in patients with poor eye protective mechanisms because it elevates both the upper and the lower eyelids, decreasing or eliminating the risk of lagophthalmos with corneal complications.
Lucci
Lucia Miriam Dumont
LM
Setor de Plástica Ocular, Faculdade de Medicina do ABC, Santo André, SP, Brasil. lucialucci08@gmail.com
Fonseca Junior
Nilson Lopes da
NL
Sugano
Débora Mayumi
DM
Silvério
Juliana
J
D001763:Blepharoptosis / Q000601:surgery*; D005143:Eyelids / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017240:Mitochondrial Myopathies / Q000601:surgery*; D011446:Prospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome