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. 2015 Mar;42(2):214-7.
doi: 10.5999/aps.2015.42.2.214. Epub 2015 Mar 16.

Treatment of Eyelid Ptosis due to Kearns-Sayre Syndrome Using Frontalis Suspension

Laurenz Weitgasser  1 , Gottfried Wechselberger  1 , Florian Ensat  1 , Rene Kaplan  1 , Michaela Hladik  1
Affiliations

Treatment of Eyelid Ptosis due to Kearns-Sayre Syndrome Using Frontalis Suspension

Laurenz Weitgasser et al. Arch Plast Surg. 2015 Mar.

Abstract

Blepharoptosis is a common indication for surgery in plastic surgery units, yet its possible underlying pathology frequently remains unidentified. A 52-year-old man with a 20-year history of progressive bilateral ptosis (right>left) presented with recurrent ptosis of both eyes; he had undergone an operation on the levator aponeurosis 12 years prior. Due to the suspicion of an underlying disease, he was evaluated further. Chronic progressive external ophthalmoplegia in transition to the more severe syndromic variant Kearns-Sayre syndrome, a mitochondrial disorder causing myopathy, was diagnosed. The patient was treated with coenzyme Q10, and he underwent ptosis surgery on both eyes. This case illustrates a potentially multi-systemic disease that was diagnosed by a further evaluation of a common symptom, in this case worsening blepharoptosis. Awareness of myopathic symptoms is necessary to prevent overlooking serious yet improvable conditions.

Keywords: Blepharoplasty; Blepharoptosis; Chronic progressive external opthalmoplegia; Kearns-Sayre syndrome.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Case presentation
(A, B) A 52-year-old male patient with a 20-year history of progressive bilateral blepharoptosis who had recurrent blepharoptosis after a previous levator aponeurosis operation on the right side 12 years earlier.
Fig. 2
Fig. 2. Intraoperative view
(A, B) Tunnels under the eyebrow were prepared with thin cannulas. Flexor carpi radialis tendon strips were guided through the tunnels as autologous sling material for frontalis suspension.
Fig. 3
Fig. 3. Immediate postoperative result
(A, B) Immediate postoperative result, after skin closure and successful ptosis adjustment of the right eye with frontalis suspension.
Fig. 4
Fig. 4. Postoperative results
(A) Results 6 months postoperatively. (B) Results 12 months postoperatively.
See this image and copyright information in PMC

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