OBJECTIVE

To determine the optimal surgical correction of eyelid lesions in senile patients with concomitant age-related changes.

MATERIAL AND METHODS

The clinical group consisted of 28 patients including 11 men and 17 women aged 63—84 years (mean 71.2±5.2). There were 13 patients with ptosis of the upper eyelid, 9 patients with inversion of the lower eyelid and 6 patients with atonic inversion of the lower eyelid. All patients underwent surgical correction of eyelid lesions. The follow-up period was 2 years. Control examination of patients was carried out after 1, 3 and 6 months.

RESULTS

In this group of patients, ptosis usually has an aponeurotic nature. Ptosis is combined with excess skin of the upper eyelid, high and uneven fold of the upper eyelid, and ptosis of the eyelashes in some cases. Transcutaneous approach and repair of levator aponeurosis are preferred for adequate correction of ptosis of the upper eyelid. To assess the lower eyelid, it is worth remembering that lateral and medial ligaments of the eyelids, tarsal plate and orbicularis oculi muscle are responsible for its stable position in horizontal plane. According to our own experience, surgery described by Fox S.A. in 1952 is one of the suitable methods for correction of atonic inversion of the lower eyelid. In case of severe inversion or its recurrence, more serious surgeries such as Kuhnt-Shimanovsky procedure and its modifications are advisable. Correction of atonic inversion is performed using the same modification of Kuhnt-Shimanovsky procedure while partial blepharoraphy may be additionally applied in extremely severe cases.

CONCLUSION

Eyelid involution in senile patients should be considered to achieve the best cosmetic and functional results. Understanding the biomechanics of eyelid tissues combined with individual approach to each patient is essential for successful surgical treatment.