I am Richard Collin and was the senior ophthalmic plastic surgeon at the largest ophthalmic hospital in London, Moorfields. I was also an honorary consultant ophthalmic surgeon at the largest children’s hospital in London, Great Ormond Street Hospital for Sick Children. I was trained in both ophthalmology and plastic surgery and have spent most of my professional life operating, lecturing, writing papers and books and teaching oculoplastic surgery.
Ptosis is one of the more difficult areas of oculoplastic surgery to get right. The choice of operation depends on the levator function and the type of ptosis with its associated features. The types of ptosis can be considered under the following headings:
Congenital – which is usually an isolated levator muscle dystrophy;
Blepharophimosis;
Progressive External Ophthalmoplegia and other causes which can be either acquired or congenital such as aponeurotic defect, neurological i.e. third nerve palsies and associated syndromes, Horner’s syndrome, myogenic, and myasthenia
The types of surgery that will be covered with video are as follows:
- Anterior approach aponeurosis repair
- Posterior approach aponeurosis repair
- Anterior levator resection
- Muller’s muscle conjunctiva resection (Putterman)
- Frontalis (brow) suspension with suture (Fox)
- Frontalis (brow) suspension with fascia lata (Crawford)
- Harvesting fascia lata
- Weakening levator muscle