Document Detail

Bell's phenomenon protects the tear film and ocular surface after frontalis suspension surgery for congenital ptosis.
MedLine Citation:
PMID:  19043946     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To assess alterations in the tear film and ocular surface after frontalis suspension repair in patients with pediatric congenital ptosis with either intact or poor Bell's phenomenon. METHODS: The study involved 15 patients (23 eyes) with poor Bell's phenomenon (group 1) and 21 patients (33 eyes) with intact Bell's phenomenon (group 2) who underwent frontalis suspension surgery using autogenous fascia lata. The control group comprised 15 age-matched subjects (30 eyes) (group 3). Corneal esthesiometry, tear film break-up time (BUT) measurement, Schirmer II tests, and vital staining were performed prospectively before surgery and 1, 3, and 6 months postoperatively. RESULTS: Group 1 had a lower mean BUT at all postoperative follow-up time points compared to group 2. Group 1 had a greater mean fluorescein staining score (FSS) at 6 months postoperatively compared to group 2. The degree of lagophthalmos strongly correlated with BUT and FSS at 6 months postoperatively in group 1, but not in group 2. In group 1, mean lagophthalmos (5.2 mm) and amount of eyelid elevation (5.8 mm) were higher in abnormal FSS eyes (n=17) than in normal FSS eyes (n=6) (3.3 and 3.9 mm, respectively). CONCLUSION: Bell's phenomenon prevents tear film instability and ocular surface damage in eyes with lagophthalmos induced by frontalis suspension surgery. In patients with poor Bell's phenomenon, ptosis correction of more than 5.5 mm or lagophthalmos of more than 5.0 mm could increase the risk of exposure keratopathy, necessitating careful postoperative monitoring.
Jin Sook Yoon; Helen Lew; Sang Yeul Lee
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric ophthalmology and strabismus     Volume:  45     ISSN:  0191-3913     ISO Abbreviation:  J Pediatr Ophthalmol Strabismus     Publication Date:    2008 Nov-Dec
Date Detail:
Created Date:  2008-12-02     Completed Date:  2008-12-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7901143     Medline TA:  J Pediatr Ophthalmol Strabismus     Country:  United States    
Other Details:
Languages:  eng     Pagination:  350-5     Citation Subset:  IM    
Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul.
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MeSH Terms
Bell Palsy / physiopathology*
Blepharoptosis / congenital*,  surgery*
Cornea / physiology*
Fascia Lata / transplantation
Oculomotor Muscles / surgery*
Ophthalmologic Surgical Procedures
Sensation / physiology
Tears / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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