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December 1989

Conjunctival Flap-Cosmetic Shell-Ptosis Procedure Treatment of Blepharoptosis in Severe Keratopathy

Author Affiliations

From the Departments of Ophthalmology, Eye and Ear Infirmary, University of Illinois at Chicago College of Medicine and the University of Chicago and Michael Reese Hospital and Medical Center.

Arch Ophthalmol. 1989;107(12):1816-1818. doi:10.1001/archopht.1989.01070020898035

• The correction of marked blepharoptosis in patients with severe or potential keratopathy will worsen the keratopathy and possibly lead to the complications of corneal ulceration and endophthalmitis. The conjunctival flap-cosmetic shell-ptosis procedure is well suited to this difficult management problem. Patients are initially treated with a conjunctival flap to protect their cornea. Subsequently they are fit with a cosmetic shell, and finally they undergo surgery to correct their ptosis. This three-stage procedure has produced excellent cosmetic and functional results in two patients, one of whom had ptosis and severe radiation-induced keratopathy following the treatment of a rhabdomyosarcoma; the other patient had severe ptosis associated with lack of corneal sensation and orbicularis function following removal of a cerebral meningioma.

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