Abstract
BackgroundDirect damage to the superior rectus (SR) muscle insertion following upper lid blepharoplasty has not been reported. We document a rare case of vertical diplopia due to direct damage to the SR muscle insertion following cosmetic upper lid blepharoplasty.Case presentationWe describe a case of 24-year-old woman with Asian eyelid. The patient had already undergone multiple cosmetic upper lid surgeries and complained of vertical diplopia immediately after her most recent surgery (levator resection with skin approach). Preoperatively, large-angle right hypotropia and severe upgaze limitation were present and noticeable ptosis was observed in the right eye. Intraoperatively, the SR muscle fibers were observed to be detached at the insertion site and severe fibrosis and adhesion surrounding the muscle was noted. After strabismus surgery, vertical strabismus was improved.ConclusionsThis case can provide valuable insight to surgeons performing ptosis surgery and blepharoplasty, particularly in cases of reoperation. Surgeons should be careful while manipulating the levator muscle or resecting deep tissues not to affect the SR muscle.
Highlights
Direct damage to the superior rectus (SR) muscle insertion following upper lid blepharoplasty has not been reported
Surgeons should be careful while manipulating the levator muscle or resecting deep tissues not to affect the SR muscle
We document a rare case of vertical diplopia due to direct damage to the SR muscle insertion following cosmetic upper lid blepharoplasty
Summary
Direct damage to the superior rectus (SR) muscle insertion following upper lid blepharoplasty has not been reported. Surgeons should be careful while manipulating the levator muscle or resecting deep tissues not to affect the SR muscle. * Correspondence: syoh@skku.edu Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea eye was over-corrected, and she underwent several surgeries performed by another plastic surgeon to correct the lid level.
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