title: Surgical treatment of a rare case of bilateral ptosis due to localized ocular amyloidosis.
abstract: We describe a rare case of a 31-year old woman with bilateral ptosis due to localized amyloidosis. She referred a nine-year history of ptosis and surgical treatment with frontalis suspension three years previously. Following complete ophthalmological examination and evaluation of the ptosis we carried out tarsal and fornix biopsy, which revealed accumulation of a weakly eosinophilic amyloid positive substance. We performed surgical correction using the levator aponeurosis-Müller's muscle complex re-adaptation technique and amyloid substance debulking in all the palpebral layers in the left eye. The material obtained was stained with hematoxylin-eosin, Congo Red, PAS and alpha-actin, which confirmed amyloid deposition. Successively, the right eye was operated in the same manner and entropion was managed by dissection and removal of amyloid from subconjunctival layers. Five years following surgery, the corrective procedure for ptosis was still effective. Surgical treatment of ptosis is very complex and requires precise indications. Appropriate management depends on the etiopathogenesis, accurate diagnosis, and clinical findings.
authors.affiliation: Ophthalmology Unit, NESMOS Department St. Andrea Hospital, Faculty of Medicine and Psychology, University of Rome "Sapienza", Via di Grottarossa 1035, Rome 00189, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Scuderi
authors.affiliation: Ophthalmology Unit, DAI Testa/Collo, Azienda Policlinico Umberto I, University of Rome "Sapienza", Viale del Policlinico 155, Rome 00161, Italy.
authors.forename: Solmaz
authors.initials: S
authors.lastname: Abdolrahimzadeh
authors.affiliation: SkinLaser, Piazzale delle Belle Arti 2, Rome, Italy.
authors.forename: Antonietta
authors.initials: A
authors.lastname: Troccola
authors.affiliation: Dipartimento di Scienze Chirurgiche e Biomediche, Sezione di Chirurgia Plastica, Università degli Studi di Perugia, Perugia, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Mazzocchi
authors.affiliation: Ophthalmology Unit, NESMOS Department St. Andrea Hospital, Faculty of Medicine and Psychology, University of Rome "Sapienza", Via di Grottarossa 1035, Rome 00189, Italy.
authors.forename: Santi Maria
authors.initials: SM
authors.lastname: Recupero
keywords: Amyloidosis, levator aponeurosis–Müller’s muscle complex re-adaptation; Pseudoptosis; Ptosis