Many neuromuscular diseases are accompanied by ptosis of myopathic origin. The main mechanism is a deficit of the eyelid levator muscle. American ophthalmologists conducted a review of the literature on the surgical treatment of this complication:
- 27 articles, each with at least four original cases, came to their attention,
- CPEO (chronic progressive external ophthalmoplegia), oculopharyngeal muscular dystrophy (OPMD) and myasthenia gravis were the most common etiologies,
- the surgical techniques and results obtained varied greatly from one team to another,
- post-operative complications, including recurrence of ptosis, are particularly frequent.
According to the authors, intentional undercorrection of the ptosis during surgery is one of the main causes of recurrence. In general, the surgeon has to find the right balance between maintaining function, durability of the surgery and protection of the cornea.
