Approach to eyelid ptosis in a federal hospital in Rio de Janeiro in 2023

Abstract

Introduction: The upper eyelid has complex anatomy, which is essential for an aesthetic appearance and proper function. Its normopositioning contributes to pleasant lines and is related to the eyebrow. The levator palpebrae and muller muscles maintain their height and excursion, along with the frontalis muscle. Ptosis can be congenital (myogenic or neurogenic) or acquired (myogenic, neurogenic, traumatic, mechanical, aponeurotic). The aesthetic evaluation considers the symmetry, shape and height of the eyelid. Ptosis is diagnosed when the upper eyelid margin to the reflex margin distance from the cornea is abnormally low. Eyelid fold asymmetry is associated with blepharoptosis and may require surgical correction. Methods: A total of 13 cases operated at the HFA from January to December 2023 were analyzed. All patients were approached anteriorly, with shortening of the aponeurosis of the eyelid levator muscle, after the aponeurotic defect was identified. Results: Of the cases approached (13), there were 7 men and 6 women. 11 bilateral cases and 2 unilateral cases. 1 case already operated on another service. 8 cases were elderly over 60 years old, of which 3 had a history of cataract correction (37.5%). Conclusion: The identification of ptosis in the preoperative evaluation with its consequent correction presented a better overall result, not only aesthetically, but mainly functionally. The MEPS aponeurosis shortening technique demonstrated a low complication rate, which was effective, meeting the needs of the patients and satisfying the surgeon.