title: Accidental lacrimal gland removal during resection of the levator palpebrae superioris muscle.
abstract: Accidental removal of the lacrimal gland is a rare complication of ptosis surgery. We report two children who underwent large unilateral levator palpebrae superioris resections (LPSr). After surgery, both patients developed dry eye. Post-operatively, the parents of both patients noticed no tears in the affected eye when their child cried. Computed tomography proved the absence of the lacrimal gland in the operated eye in both patients. Oculoplastic surgeons should pay close attention to the anatomy of the levator muscle and its proximity to surrounding tissues in order to avoid lesions on important orbital structures, including the lacrimal gland, and to avoid the development of long-term dry eye.
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.|Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Patricia
authors.initials: P
authors.lastname: Akaishi
authors.affiliation: Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.|Department of Ophthalmology, Complejo Asistencial Palencia, Palencia, Spain.
authors.forename: Alicia
authors.initials: A
authors.lastname: Galindo-Ferreiro
authors.affiliation: Division of Radiology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.|Mansoura Faculty Of Medicine, Diagnostic Radiology Department, Egypt.
authors.forename: Sahar M
authors.initials: SM
authors.lastname: Elkhamary
authors.affiliation: Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Zakeya
authors.initials: Z
authors.lastname: Al-Sadah
authors.affiliation: Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Alberto
authors.initials: A
authors.lastname: Galvez-Ruiz
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.|Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: A Augusto
authors.initials: AA
authors.lastname: Cruz
mesh_terms: D016569:Blepharophimosis / Q000601:surgery*; D002648:Child; D015352:Dry Eye Syndromes / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D007765:Lacrimal Apparatus / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D019300:Medical Errors / Q000009:adverse effects*; D009801:Oculomotor Muscles / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D014057:Tomography, X-Ray Computed