Upper eyelid muscle weakness double eyelid surgery

A girl who loves beauty may have a small request for herself to have a pair of big, lively and clear eyes, so double eyelids are essential. Now, this is not a difficult problem for girls with single eyelids. A double eyelid surgery can solve this little trouble. However, how much do you know about upper eyelid surgery? Today, let’s talk about upper eyelid surgery using the levator palpebrae superioris surgery for upper eyelid muscle weakness.

Is it necessary to have an eyelid levator surgery? Eyelid levator surgery is a surgical method to improve ptosis. Who needs to have an eyelid levator surgery? Can you have double eyelid surgery without an eyelid levator? Let's learn about the indications for eyelid levator surgery!

Is upper eyelid levator surgery necessary?

Not everyone needs to undergo the levator palpebrae superioris surgery. So who needs the levator palpebrae superioris surgery? In fact, it is mainly people with mild to moderate ptosis caused by ptosis muscle weakness who need to undergo the levator palpebrae superioris surgery to improve ptosis and dull eyes. If the ptosis is severe, there is no need to perform levator palpebrae superioris surgery. It is a better choice to choose frontalis muscle flap suspension for correction.

Definition and criteria for ptosis

Definition: In general, we call the difficulty in opening the eyes and lifting the eyelids due to insufficient strength of the levator palpebrae superioris muscles ptosis. Ptosis is generally divided into mild, moderate and severe levels.

Judgment criteria: When looking straight ahead, if the eyelid margin covers the upper edge of the pupil, this condition is mild; if it covers the upper third of the pupil, this condition is moderate; if it covers half of the pupil, then this condition is severe.

Indications for upper eyelid levator surgery

Is levator palpebrae superioris surgery necessary? According to the indications of levator palpebrae superioris surgery, levator palpebrae superioris surgery is suitable for bilateral or unilateral mild or moderate congenital ptosis (under normal circumstances, when the upper eyelid margin covers the upper edge of the cornea ≤2mm with the eyes open, and ptosis can be diagnosed when the coverage is >2mm after excluding the influence of the frontalis muscle), and those whose levator palpebrae superioris muscles still have partial function (the muscle strength of the levator palpebrae superioris muscles is 5mm or more). In addition, palpebrae levator muscle surgery can also be used for acquired aponeurotic ptosis.

Causes of ptosis: myogenic ptosis

Myogenic ptosis can be either congenital or acquired. Congenital cases are mostly caused by poor development of the levator palpebrae superioris muscle, and may also be caused by developmental disorders of the central and peripheral nerves that control the levator palpebrae superioris muscle. Its pathological manifestations are the disappearance of the transverse stripes of the levator palpebrae superioris muscle fibers, a decrease in their number, disordered course, and replacement by fibrous tissue and adipose tissue. The degree of the defect is proportional to the severity of ptosis. Clinically, such patients not only show weakened contraction function of the levator palpebrae superioris muscle, but also decreased relaxation function, namely, upper eyelid hysteresis. Acquired ones are mainly caused by local or diffuse muscle diseases, such as myotonia syndrome, progressive muscular dystrophy and myasthenia gravis.

Causes of ptosis: aponeurotic ptosis

It is caused by a tear or rupture of the levator aponeurosis due to various reasons. It is more common in spontaneous or degenerative changes such as senile ptosis, but can also be seen in trauma, intraocular surgery or wearing hard corneal contact lenses [26-29]. At this time, the levator palpebrae superioris muscle strength is good, the muscle strength assessment value is mostly >8 mm, and the superior rectus muscle function is normal.

Causes of ptosis: neurogenic ptosis

It is caused by paralysis of the oculomotor nerve or its branches, and may be accompanied by dysfunction of one or more extraocular muscles innervated by the oculomotor nerves, most often manifested as ptosis with superior rectus muscle dysfunction.

Causes of ptosis: mechanical ptosis

It is caused by scar-like thickening of the eyelids due to various factors. It can be seen due to trauma, tumor invasion or surgery.