Conjunctival flap-cosmetic shell-ptosis procedure. Treatment of blepharoptosis in severe keratopathy
A. M. Putterman
Department of Ophthalmology, University of Illinois, Chicago College of Medicine.
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.