Anatomic Characteristics of Upper Eyelid Structures Important in Ptosis Surgery.

Shin, Hanho; Kim, Jaeho; Kwon, lltaek

Original Article

Journal of the Korean Ophthalmological Society 1993;34(7):599-605.
Published online July 1, 1993.

Anatomic Characteristics of Upper Eyelid Structures Important in Ptosis Surgery.

Hanho Shin, Jaeho Kim, lltaek Kwon

Department of Ophthalmology, College of Medicine, Soonchunhyang University, Korea.

안검하수증 수술을 위한 상안검의 형태학적 특징

김재호(Jae Ho Kim),신환호(Hwan Ho Shin),권일택(Il Taek Kwon)

Abstract

Exact understanding of the upper eyelids is essential to the success of an anterior surgical approach for the correction of blepharoptosis. Therfore, we undertook this study using cadaver dissection, histologic sections, surgical observations, and review of MRI findings to gain a better understanding of the anatomical characteristics of the orbital septum and associated connective tissue structures which are important in ptosis surgery. The basic distinction of the upper eyelid structures between Oriental and Occidental is the relationship of the orbital septum and the levator aponeurosis. The orbital septum appears as a thick multilayered connective tissue originating just inside the superior orbital rim, but its inferior extension become thin progressively and blends with levator aponeurosis on an average of 1.6mm below the superior tarsal horder. Therefore the preaponeurotic fat is allowed to proceed to the anterior tarsal surface, resulting in a characteristic appearance of oriental eyelids. The levator aponeurosis maintains its thick and obvious structure continuously to the anterior tarsal surface near the lower margin of the upper lid. We resected levator aponeurosis with Muller's muscle which plays a important role in lid elevation for the correction of congenital htepharoptosis, and obtained excellent results.

Key Words: Anatomy of upper eyelids;Levator aponeurosis;Muller's muscle;Orbital septum;Ptosis surgery