title: Bilateral lid/brow elevation procedure for severe ptosis in Kearns-Sayre syndrome, a mitochondrial cytopathy.
abstract: BACKGROUND
  The purpose of this work was to determine the effectiveness and possible complications encountered with bilateral fascia lata lid suspension used to correct blepharoptosis in patients with Kearns-Sayre syndrome.
  
  
  METHODS
  This was a retrospective study of seven patients with Kearns-Sayre syndrome who had a minimum of 1 year of follow-up. A bilateral fascia lata sling was used to correct the ptosis. Preoperative and postoperative measurements of the vertical lid fissure width (VFW) and marginal reflex distance (MRD) were performed. The Student's t-test was used to analyze the results.
  
  
  RESULTS
  The mean preoperative VFW and MRD measurements were 4±2.45 mm and 0.14±0.92 mm, respectively. The mean postoperative VFW and MRD measurements were 7.71±1.85 mm, and 2.86±1.69 mm, respectively. All preoperative and postoperative values were considered to be statistically significant (P<0.01). Adequate elevation of the lids was obtained in all patients, both functionally and aesthetically. All of the patients showed a mild symmetric postoperative inferior version lagophthalmos, and one patient developed corneal ulceration and scarring due to corneal exposure and a weak Bell's phenomenon.
  
  
  CONCLUSIONS
  The surgical technique described to correct the blepharoptosis found in patients with Kearns-Sayre syndrome was found to be efficient and relatively safe. The correction should be conservative to decrease the risk of postoperative corneal damage that occurred in one patient.
authors.affiliation: Department of Ophthalmology, Fluminense Federal University, Niterói, Brazil ; Oculoplastic Surgery Department, 38th Infirmary of the Santa Casa de Misericordia do Rio de Janeiro, Instituto Ivo Pitanguy, Pontifícia Universidade Catolica do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Roberto
authors.initials: R
authors.lastname: Sebastiá
authors.affiliation: Clinica Gretter, Università degli Studi di Catania, Catania, Italy.
authors.forename: Ester
authors.initials: E
authors.lastname: Fallico
authors.affiliation: Facoltà di Medicina e Chirurgia, Università degli Studi di Catania, Catania, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Fallico
authors.affiliation: Hospital da Plástica, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Fortuna
authors.affiliation: Oculoplastic Surgery Department, 38th Infirmary of the Santa Casa de Misericordia do Rio de Janeiro, Instituto Ivo Pitanguy, Pontifícia Universidade Catolica do Rio de Janeiro, Rio de Janeiro, Brazil ; Post-Graduate Program in Physiopathology in Surgical Science, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Sergio
authors.initials: S
authors.lastname: Lessa
authors.affiliation: Department of Ophthalmology, Fluminense Federal University, Niterói, Brazil.
authors.forename: Guilherme Herzog
authors.initials: GH
authors.lastname: Neto
keywords: Kearns-Sayre syndrome; blepharoptosis; chronic progressive external ophthalmoplegia; fascia lata lid suspension