title: Evaluation of moderate and severe blepharoptosis correction using the interdigitated part of the frontalis muscle and orbicularis oculi muscle suspension technique: A cohort study of 235 cases.
abstract: BACKGROUND
  Blepharoptosis is defined as an abnormally low-lying upper eyelid margin in the primary gaze, causing vertical narrowing of the palpebral fissure. It is difficult to achieve consistently satisfactory results in moderate or severe cases despite many surgical methods being available to correct them.
  
  
  METHODS
  Between January 2001 and December 2014, a retrospective cohort study was conducted using medical records and perioperative photographs of 235 patients. All the patients, having presented with moderate or severe bilateral or unilateral blepharoptosis, underwent blepharoptosis correction with the interdigitated orbicularis oculi-frontalis muscle flap suspension technique and contemporaneous double-eyelid surgery. The results, including complications, were followed up and evaluated.
  
  
  RESULTS
  The mean age of the patients was 17.4 years (range 3-50 years). The follow-up period ranged from 6 months to 8 years, with a mean follow-up of 13 months. Long-term postoperative complications included undercorrection (3.0%), overcorrection (0.7%) and eyelid fold deformity (4.0%). No ectropion, entropion, fornix conjunctival prolapse or exposure keratitis was noted.
  
  
  CONCLUSIONS
  Blepharoptosis correction with interdigitated orbicularis oculi-frontalis muscle flap suspension is an effective technique for the management of moderate or severe blepharoptosis. The results demonstrated very low complication rates and substantial cosmetic and functional improvement using simple manipulation.
authors.affiliation: Head & Neck Cosmetic Surgery Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Chinese Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing 100144, PR China.
authors.forename: Tailing
authors.initials: T
authors.lastname: Wang
authors.affiliation: Head & Neck Cosmetic Surgery Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Chinese Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing 100144, PR China.
authors.forename: Xiuqi
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Plastic Surgery, Hebei General Hospital, Hebei Province, PR China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Wang
authors.affiliation: Head & Neck Cosmetic Surgery Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Chinese Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing 100144, PR China.
authors.forename: Qianwen
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Head & Neck Cosmetic Surgery Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Chinese Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing 100144, PR China.
authors.forename: Wuyan
authors.initials: W
authors.lastname: Li
authors.affiliation: Head & Neck Cosmetic Surgery Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Chinese Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing 100144, PR China.
authors.forename: Lu
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Head & Neck Cosmetic Surgery Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Chinese Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing 100144, PR China.
authors.forename: Weiming
authors.initials: W
authors.lastname: Song
authors.affiliation: Head & Neck Cosmetic Surgery Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Chinese Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing 100144, PR China. Electronic address: wangjiaqi@psh.pumc.edu.cn.
authors.forename: Jiaqi
authors.initials: J
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D001763:Blepharoptosis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005143:Eyelids / Q000601:surgery; D005152:Facial Muscles / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000637:transplantation*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D013524:Surgical Flaps; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult
keywords: Frontal muscle flap; Interdigitated; Moderate or severe blepharoptosis; Orbicularis oculi muscle