Abordaje anterior versus posterior en la cirugía de la ptosis palpebral

La ptosis palpebral se define como la caida del parpado superior. Analizar los resultados obtenidos con su correccion quirurgica y determinar la efectividad terapeutica con diferentes tecnicas y vias de abordaje. Se realizo un estudio descriptivo, prospectivo y longitudinal con una casuistica de 32 pacientes (50 ojos) operados de ptosis entre mayo de 2005 a marzo de 2006. La tecnica y via de abordaje quirurgico que se aplico la en cada caso, segun el grado de severidad clinica (ligera moderada o severa) y su efectividad, se evaluo segun la disminucion en mm de la distancia margen-reflejo posoperatoria. Las tecnicas quirurgicas fueron: reforzamiento y reinsercion de la aponeurosis, supramaxima, suspension al frontal y abordaje posterior. La distancia margen-reflejo posoperatoria disminuyo de 1,2, 2,2 y 3,5 mm en ptosis ligeras moderadas y severas respectivamente. Si se selecciona adecuadamente la via de abordaje, ambas aportan buenos resultados en la correccion de la ptosis. Palpebral ptosis is defined as the upper eyelid fall. To analyze the results of the surgical correction of palpebral ptosis and to determine its therapeutical effectiveness with various techniques and approach methods. A prospective, longitudinal and descriptive study was performed on 32 patients (50 eyes) operated on from ptosis covering May, 2005 through March, 2006. The surgical technique and approach method applied to each case, taking clinical severity into account (slight, moderate and severe), and their effectiveness were evaluated based on postoperative margin-reflex distance reduction in mm. The surgical techniques were reinforcement and reinsertion of aponeurosis, supramaxima, frontalis suspension and posterior approach. Postoperative margin-reflex distance was reduced by (1.2, 2.2 and 3.5 )mm in slight, moderate and severe ptosis respectively. The right selection of the surgical technique and the approach method helps in achieving good results in ptosis correction.