Treatment of blepharoptosis with pseudo-Graefe phenomenon caused by oculomotor nerve paralysis: report of three cases

Objective To explore the treatment of unilateral blepharoptosis caused by oculomotor nerve paralysis with pseudo-Graefe phenomenon after craniocerebral trauma or operation. Methods Three patients suffered from blepharoptosis caused by oculomotor nerve paralysis with pseudo-Graefe phenomenon were collected in this study and the modified levator resection technique was applied to correct ptosis. The observation index after operation included the height of upper palpebral margin, the radian of double eyelid, the change of eye movement and the corresponding upper eyelid height, the eye closure function and the incidence of exposure keratitis. Results One case of oculomotor nerve palsy with moderate ptosis achieved an ideal height of upper eyelid after surgery, two cases of oculomotor nerve palsy with severe ptosis were undercorrection. All the three patients had smooth double eyelid radian, no obvious change of eye movement and corresponding upper eyelid height compared with preoperative. The two severe ptoses could close eyes well, but the moderate ptosis patient couldnot close eyes completely. Conclusions The technique of modified levator resection is an effective method to treat the moderate ptosis caused by oculomotor nerve paralysis with pseudo-Graefe phenomenon, but the results are unfavorable in the treatment of severe ptosis. Key words: Oculomotor nerve; Paralysis; Blepharoptosis; Pseudo-Graefe phenomenon, ptosis; Modified levator resection technique