Clinical Significance of Whitnall Ligament Structure
Study Details
Study Description
Brief Summary
Prospective clincal study to relate the structure of Whitnall ligament in cases of congenital ptosis to the severety of ptosis and the postoperative results.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
The study will be a prospective obsevational study. It will include patients (2-16 years old) who will undergo levator resection for simple congenital ptosis correction in Ophthalmology Department of Menoufia University Hospital.
Patients will be divided into 3 groups, 15 patients in each. Group I for mild ptosis, Group II for moderate ptosis Group 3 for severe ptosis.
Exclusion criteria included any patients with previous ptosis or any eyelid surgery and patients with a non congenital ptosis.
Patients included in the study well be informed about the research and the surgical maneuver which will be used with full discussion of all details regarding the postoperative follow up and the potential complications. A written consent in Arabic will then be taken from the parents of the patients
Preoperative assessment will include Complete ophthalmological examination including; Margin to Reflex Distance 1 (MRD1), Vertical Fissure Height (VFH), Levator function (LF), and eyelid crease shape and position.
Intraoperative assessment will include Whitnall ligament structure assessment including:
-
The level (the length from the insertion of the levator aponeurosis to Whitnall's ligament)
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Shape (definite band-like, weak string, undifferentiated)
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Tightness.
Postoperative assessment will be on scheduled visits at first week, one month, 3 months and 6 months postoperatively and will include MRD1, VFH, LF, and lagophthalmos measurements
Results will be documented and tabulated and statistically managed.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Mild congenital ptosis children with mild congenital ptosis |
Procedure: Levator resection
Eyelid crease incision Dissection of the levator aponeurosis to the level of Whitnall ligament. Assessment of the structure of Whitnal ligament. Resection of a calculated part of the aponsurosis. re-attachment of the aponeurosis to the tarsus Incision closure with crease formation
|
| Moderate congenital ptosis children with moderate congenital ptosis |
Procedure: Levator resection
Eyelid crease incision Dissection of the levator aponeurosis to the level of Whitnall ligament. Assessment of the structure of Whitnal ligament. Resection of a calculated part of the aponsurosis. re-attachment of the aponeurosis to the tarsus Incision closure with crease formation
|
| Severe congenital ptosis children with severe congenital ptosis |
Procedure: Levator resection
Eyelid crease incision Dissection of the levator aponeurosis to the level of Whitnall ligament. Assessment of the structure of Whitnal ligament. Resection of a calculated part of the aponsurosis. re-attachment of the aponeurosis to the tarsus Incision closure with crease formation
|
Outcome Measures
Primary Outcome Measures
- Success of levator resection in relation to structure of Whitnall ligament [An average of 1 year]
Relating the structure of the ligament with the degree of severity of ptosis by studying its position, shape and tightness in all cases during surgery
Eligibility Criteria
Criteria
Inclusion Criteria:
- Congenital ptosis
Exclusion Criteria:
-
Previous ptosis surgery
-
Non congenital ptosis
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Ophthalmology Department, Menoufia University Hospital | Shibīn Al Kawm | Menoufia | Egypt |
Sponsors and Collaborators
- Menoufia University
Investigators
- Study Chair: Richard C Allen, Department of Ophthalmology, Cullen Eye Institute,
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- OPHTH2/2020