title: Two-Stage Correction of Blepharophimosis Syndrome: Analysis of Surgical Outcome.
abstract: OBJECTIVE
  To evaluate the outcome of surgical correction of blepharophimosis syndrome.
  
  
  METHODS
  A retrospective, non-randomized, interventional case series.
  
  
  METHODS
  Ten patients undergoing surgical correction of blepharophimosis syndrome in 2 stages were reviewed. In the first stage, correction of epicanthic fold and telecanthus was done by either Y-V plasty or Roveda procedure with or without medial canthal tendon shortening. In the second stage, ptosis correction was done by bilateral frontalis sling. The preoperative and postoperative ratio of intercanthal distance (ICD) to horizontal palpebral fissure length (HPFL) was compared to assess the outcome of surgical correction of blepharophimosis. The ratio was graded as good (ratio < 1.3), suboptimal (ratio between 1.3 and 1.5), and poor (ratio > 1.5). The outcome of ptosis correction was graded as good, moderate, and poor.
  
  
  RESULTS
  Of 10 patients, 5 (50%) underwent Y-V plasty, and 5 (50%) underwent Roveda procedure. Medial canthal tendon shortening was done in 5 patients (50%) having a preoperative ICD of 35 mm or more. After surgical correction, mean reduction in ICD was 4.8 mm (P < 0.0001), and mean improvement in HPFL was 5.45 mm (P < 0.0001). The mean ICD to HPFL ratio changed from 2.02 to 1.31 after surgery, which was statistically significant (P < 0.0001). Two patients (20%) had a ratio greater than 1.5. Nine patients (90%) had either good or moderate ptosis correction after bilateral frontalis sling with silicone rod.
  
  
  CONCLUSIONS
  Functionally and cosmetically acceptable outcome can be achieved after surgical correction of blepharophimosis syndrome in 2 stages.
authors.affiliation: From the *Eye Infirmary and Training Complex and †Institute of Community Ophthalmology, Chittagong, Bangladesh.
authors.forename: Murtuza
authors.initials: M
authors.lastname: Nuruddin
authors.forename: Munirujzaman
authors.initials: M
authors.lastname: Osmani