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At least 19 recordsLinked to original sources
PubMed2006

Superior tarsectomy augments super-maximum levator resection in correction of severe blepharoptosis with poor levator function.

OBJECTIVE: To determine if a superior tarsectomy improves the ptosis corrective ability of the super maximum levator resection in cases of severe blepharoptosis with poor levator function (less than 5 mm). DESIGN: Retrospective, consecutive case series. PARTICIPANTS: Patients who underwent super maximum levator resection with (8 eyelids) or without superior tarsectomy (10 eyelids) at one institution. METHODS: Chart review of patients who underwent super maximum levator resection with or without superior tarsectomy. Data regarding eyelid position, surgical outcome, and postoperative complications were evaluated. MAIN OUTCOME MEASURES: Margin reflex distance-1 (distance [mm] between corneal light reflex and upper eyelid margin), bilateral eyelid symmetry, and postoperative complications. RESULTS: A statistically significant improvement in ptosis correction was demonstrated when integrating the superior tarsectomy with the super maximum levator resection (P = 0.029). In addition, the superior tarsectomy significantly decreased the incidence of undercorrection (margin reflex distance-1 values less than 2.0 mm) compared with the super-maximum levator resection alone (12.5% vs. 70%; P = 0.023). Improved postoperative eyelid symmetry within 1.0 and 1.5 mm was demonstrated in cases treated by the superior tarsectomy. Postoperative complications were similar in both treatments. CONCLUSIONS: The super maximum levator resection combined with superior tarsectomy can correct severely ptotic eyelids with Berke levator function ranging from 3 to 4.5 mm.

Adult↗
PubMed2002

A new algorithm for ptosis repair using conjunctival Müllerectomy with or without tarsectomy.

PURPOSE: To determine the predictability of a new algorithm for determining the amount of tissue resection for conjunctival Müllerectomy with or without tarsectomy blepharoptosis repair. METHODS: Consecutive case series of all patients undergoing conjunctival Müllerectomy with or without tarsectomy ptosis repair from October 1999 to September 2001. Each patient underwent excision according to a new algorithm for determining the amount of tissue excision. The amount resected was determined by the following formula: 9 mm of conjunctiva and Müller muscle + x mm of tarsus, where x = distance of undercorrection after phenylephrine testing. RESULTS: Sixty-eight consecutive patients underwent 70 cases of conjunctival Müllerectomy with or without tarsectomy ptosis repair on 117 eyelids, using a new algorithm for tissue excision. Forty-seven cases were bilateral and 23 were unilateral. Postoperative symmetry was found in 58 of 67 patients (87%) after 1 surgery. Patient satisfaction based on symmetry, contour, and height after 1 repair was achieved in 64 of 67 patients. There were no overcorrections. Two patients underwent successful reoperation with a second conjunctival Müllerectomy with or without tarsectomy operation. CONCLUSIONS: This modified algorithm and technique quantifies conjunctival Müllerectomy with or without tarsectomy ptosis surgery and yields predictable results.

Algorithms↗
PubMed2001

[Anterior tarsectomy for cavus foot. Retrospective study of 52 cases].

The authors reviewed 34 patients treated by tarsectomy for idiopathic pes cavus deformity between 1977 and 1996. Fifty two feet were treated surgically. All patients had undergone previous conservative treatment. The average age was 40 years. Podoscopic examination revealed 24 cavus feet stage 2, 28 cavus feet stage 3, adduction of the forefoot in 15 cases and an equinus deformity in 8 cases. On radiographic examination, Djian-Annonier's angle was 108 degrees on average. All patients were evaluated with a minimum ot two years follow-up, according to the evaluation system of the Massachusetts General Hospital. With an average follow-up of six years and six months, overall results were; 65.5% very good and good, 21% fair, 13.5% poor. The morphological correction was poor in 9 cases. Djian-Annonier's angle was 125 degrees on average. A number of cavus feet do not justify surgical treatment, because they are well tolerated, sometimes with orthopedic orthoses. Tarsectomy must be avoided in neurological conditions. We do not advise release of soft tissue or Dwyer's calcaneal osteotomy. In our opinion, the choice indication for anterior tarsectomy is the nonrigid cavus foot. It must be combined with lengthening of the Achilles tendon when a deficit of dorsiflexion of the foot persists following tarsectomy. According to their importance, associated deformations will be treated in the same operative session or not.

Adolescent↗
PubMed2026

Wedge tarsectomy using patient specific instrumentation for complex multiplanar foot deformity Reconstruction: A prospective case series.

BACKGROUND: Bony correction in complex cavovarus deformities is often multiplanar. We examine our results following wedge tarsectomy (WT) using patient-specific instrumentation (PSI). METHODS: This single-centre, prospective case series evaluated noncorrectable cavovarus feet undergoing PSI-guided WT. Accuracy of PSI guides/plans, operative duration, and adjunctive procedures were recorded. Weightbearing CT (WBCT) measurements and PROM scores were recorded preoperatively and postoperatively, with 1 year follow-up. Data was then statistically analysed. RESULTS: Eleven patients were included. Planned correction was achieved (two required minor intraoperative adjustments to the initial osteotomy and nine required adjunctive procedures). Mean operative time was 135 min. Postoperative improvements were significant radiologically and in MOxFW walking distance. All fused by 3 months, with no significant complications. CONCLUSION: PSI-guided wedge tarsectomy safely achieves predictable multiplanar corrections. Our unit's experience has been excellent, with improvement in patients' walking, particularly with larger deformity corrections. LEVEL OF EVIDENCE: Level IV, prospective case series.

Humans↗
PubMed1995

The tarsectomy operation of A.P.L. Gillet de Grandmont (1837-1894) and its periodic rediscovery.

During the past two centuries, several methods of ptosis repair have been described and refined, but each method has typically been subject to cycles of popularity, neglect and reincarnation. Repair of ptosis through partial resection of the tarsus is one such example. Although Sir William Bowman included tarsectomy with his historic levator resections, the French ophthalmologist, A.P.L. Gillet de Grandmont was the first to specifically emphasize resection of tarsus for the correction of ptosis. Yet contemporary advocates of tarsectomy for ptosis repair have generally failed to recognize Gillet de Grandmont's contribution and his role in the history of ptosis surgery. For this reason, a review of this subject is presented.

Blepharoptosis↗
PubMedDate not supplied

Revised tarsectomy for correction of relapsed clubfoot.

A modification of the wedge tarsectomy used for correction of components of talipes equinovarus that helps preserve the length of the foot is presented. The procedure is demonstrated with the report of a case that was treated successfully. Correction of deformity in all three body planes in the relation of the forefoot to the rearfoot can be achieved with this combination tarsectomy-bone graft procedure that will simultaneously prevent gross shortening of the foot.

Adult↗
PubMed1993

Whitnall's sling with superior tarsectomy for the correction of severe unilateral blepharoptosis.

The management of severe unilateral blepharoptosis is problematic. In the presence of poor levator function, conventional surgical techniques frequently do not adequately elevate a ptotic eyelid. From May 1988 through July 1991, we used 4- to 5-mm external resections of the superior tarsus in conjunction with a maximal aponeurectomy (Whitnall's sling procedure) to augment blepharoptosis correction in selected cases of severe unilateral blepharoptosis. Seventeen (68%) of 25 patients with poor levator function blepharoptosis who underwent this new surgical procedure achieved a lid height within 1 mm of the opposite lid with good or excellent ocular function, cosmesis, and eyelid crease formation. Mild to moderate degrees of exposure keratopathy developed early in the postoperative period in all patients. This exposure keratopathy ultimately resolved in most patients. Superior tarsectomy safely augments the blepharoptosis correction of a Whitnall sling procedure in severe blepharoptosis, improving the results of aponeurotic surgery in patients with severe unilateral blepharoptosis.

Adolescent↗
PubMed1976

[Anterior tarsectomy for pes cavus: indications and long term results].

The authors have reviewed 48 cases of pes cavus treated by anterior tarsectomy with an average follow-up of two years. The clinical, anatomical and radiological features of the condition are described. The results were satisfactory in two-thirds of the cases. Failures were related to unsatisfactory indications such as children under thirteen, progressive neurological disease or associated impairment of the ankle joint (arthritis, dislocation). The indications for the procedure are discussed and compared with those for Dwyer calcaneal osteotomy, triple arthrodesis, soft tissue operations (Steindler) or resection of the metatarsal heads.

Adolescent↗
PubMed1956

Tarsectomy.

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Entropion↗
PubMed1977

Anterior tarsectomy reoperation for upper eyelid blepharoptosis or contour abnormalities.

In five cases, a simplified anterior tarsal resection corrected complicated upper eyelid blepharoptosis and contour abnormalities. One case of residual blepharoptosis after levator muscle resection was corrected by resecting an amount of tarsus equal to the desired amount of correction. Two cases of upper eyelid blepharoptosis resulting from overcorrected levator muscle recession were corrected in the same manner. In one case of residual segmental blepharoptosis of the upper eyelid causing a contour abnormality, we resected a segment of tarsus corresponding to the amount of blepharoptosis in the affected segment of the eyelid. In one patient who developed a contour abnormality after a Fasanella procedure with segmental blepharoptosis nasally and overcorrection temporally, a segment of tarsus resected nasally and inserted temporally created an even contour. Anterior tarsal resection is a simple method of revising the upper eyelid level of contour in situations where the upper eyelid anatomy has been distorted by previous surgery.

Adult↗
PubMed1952

Tarsectomy.

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Eyelids↗