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Kiyoshi Matsuo - One of the best experts on this subject based on the ideXlab platform.

  • Surgical desensitisation of the mechanoreceptors in Müller's muscle relieves chronic tension-type headache caused by tonic reflexive contraction of the occipitofrontalis muscle in patients with Aponeurotic Blepharoptosis.
    Journal of plastic surgery and hand surgery, 2012
    Co-Authors: Kiyoshi Matsuo, Ryokuya Ban
    Abstract:

    Proprioceptively innervated intramuscular connective tissues in Muller's muscle function as exterior mechanoreceptors to induce reflex contraction of the levator and occipitofrontalis muscles. In Aponeurotic Blepharoptosis, since the levator aponeurosis is disinserted from the tarsus, stretching of the mechanoreceptors in Muller's muscle is increased even on primary gaze to induce phasic and tonic reflexive contraction of the occipitofrontalis muscle. It was hypothesised that in certain patients with Aponeurotic Blepharoptosis, the presence of tonic reflexive contraction of the occipitofrontalis muscle due to the sensitised mechanoreceptors in Muller's muscle, can cause chronic tension-type headache (CTTH) associated with occipitofrontalis tenderness. To verify this hypothesis, this study evaluated (1) what differentiates patients with CTTH from patients without CTTH, (2) how pharmacological contraction of Muller's smooth muscle fibres as a method for desensitising the mechanoreceptors in Muller's muscle affects electromyographic activity of the frontalis muscle, and (3) how surgical Aponeurotic reinsertion to desensitise the mechanoreceptors in Muller's muscle electromyographically or subjectively affects activities of the occipitofrontalis muscle or CTTH. It was found that patients had sustained CTTH when light eyelid closure did not markedly reduce eyebrow elevation. However, pharmacological contraction of Muller's smooth muscle fibres or surgery to desensitise the mechanoreceptor electromyographically reduced the tonic contraction of the occipitofrontalis muscle on primary gaze and subjectively relieved Aponeurotic Blepharoptosis-associated CTTH. Over-stretching of the mechanoreceptors in Muller's muscle on primary gaze may induce CTTH due to tonic reflexive contraction of the occipitofrontalis muscle. Therefore, surgical desensitisation of the mechanoreceptors in Muller's muscle appears to relieve CTTH.

  • Electrical stimulation to the trigeminal proprioceptive fibres that innervate the mechanoreceptors in Müller's muscle induces involuntary reflex contraction of the frontalis muscles.
    Journal of plastic surgery and hand surgery, 2012
    Co-Authors: Kiyoshi Matsuo, Yoshiro Osada, Ryokuya Ban
    Abstract:

    The levator and frontalis muscles lack interior muscle spindles, despite consisting of slow-twitch fibres that involuntarily sustain eyelid-opening and eyebrow-raising against gravity. To compensate for this anatomical defect, this study hypothetically proposes that initial voluntary contraction of the levator fast-twitch muscle fibres stretches the mechanoreceptors in Muller's muscle and evokes proprioception, which continuously induces reflex contraction of slow-twitch fibres of the levator and frontalis muscles. This study sought to determine whether unilateral transcutaneous electrical stimulation to the trigeminal proprioceptive fibres that innervate the mechanoreceptors in Muller's muscle could induce electromyographic responses in the frontalis muscles, with monitoring responses in the orbicularis oculi muscles. The study population included 27 normal subjects and 23 subjects with Aponeurotic Blepharoptosis, who displayed persistently raised eyebrows on primary gaze and light eyelid closure. The stimulation induced a short-latency response in the ipsilateral frontalis muscle of all subjects and long-latency responses in the bilateral frontalis muscles of normal subjects. However, it did not induce long-latency responses in the bilateral frontalis muscles of subjects with Aponeurotic Blepharoptosis. The orbicularis oculi muscles showed R1 and/or R2 responses. The stimulation might reach not only the proprioceptive fibres, but also other sensory fibres related to the blink or corneal reflex. The experimental system can provoke a monosynaptic short-latency response in the ipsilateral frontalis muscle, probably through the mesencephalic trigeminal proprioceptive neuron and the frontalis motor neuron, and polysynaptic long-latency responses in the bilateral frontalis muscles through an unknown pathway. The latter neural circuit appeared to be engaged by the circumstances of Aponeurotic Blepharoptosis.

  • A Contractile Network of Interstitial Cells of Cajal in the Supratarsal Mueller's Smooth Muscle Fibers With Sparse Sympathetic Innervation.
    Eplasty, 2012
    Co-Authors: Shunsuke Yuzuriha, Kiyoshi Matsuo, Ryokuya Ban, Shiharu Yano, Tetsuji Moriizumi
    Abstract:

    Mueller's smooth muscle fibers are serially located between the levator muscle fibers and the tarsus, under the levator aponeurosis; we have previously reported that Mueller's smooth muscle fibers are innervated by unmyelinated sympathetic efferent fibers, and furthermore, that the intramuscular connective tissues interspersed among the smooth muscle fibers are innervated by myelinated trigeminal proprioceptive afferent fibers (Fig ​(Fig11a).1,2 The latter fibers function as mechanoreceptors, inducing reflexive contraction of 2 different eyelid-opening muscles, the levator and frontalis muscles. Voluntary contraction of the levator fast-twitch muscle fibers stretches the mechanoreceptors in Mueller's muscle to evoke trigeminal proprioception, thereby stimulating both the oculomotor neurons and the frontalis motoneurons to induce reflexive contraction of the levator and frontalis slow-twitch muscle fibers, respectively. This results in involuntary continuous lifting of the eyelid and eyebrow to maintain a visual field corresponding to changes in vertical gaze as a type of length servomechanism.3-9 Figure 1 A neurophysiological schema involuntarily maintains an adequate visual field by reflexive contraction of the levator and frontalis slow-twitch fibers during changes in vertical gaze as a type of length servomechanism. (a) Normal condition. (b) Aponeurotic ... Aponeurotic Blepharoptosis is caused by disinsertion of the levator aponeurosis from the tarsus and elongated attenuation of the levator aponeurosis and underlying Mueller's muscle (Figs ​(Figs1b1b and ​and22a).10-12 During eyelid opening in patients with Aponeurotic Blepharoptosis, the retractile force of the levator muscle is transmitted to the tarsus via the sympathetically innervated Mueller's muscle instead of the aponeurosis. It has been empirically noted that the eye will open quite normally despite total disconnection of the aponeurosis, as long as there is a normally functioning Mueller's muscle.13 Therefore, in patients with Aponeurotic Blepharoptosis, stretching of Mueller's muscle must induce contraction of Mueller's smooth muscle fibers for transmission of the retractile force from the levator muscle to the tarsus. Figure 2 Changes in the upper eyelid retraction distance (UERD) before and after phenylephrine-mediated contraction of the posterior Mueller's muscle that faces the conjunctiva palpebrae. (a) A 58-year-old woman with Aponeurotic Blepharoptosis prior to administration ... As controversy persists around the identity and physiological roles of the mechanoreceptor in Mueller's muscle, we sought to clinically and histologically investigate Mueller's muscle.

  • Selective alpha 1A-adrenoceptor stimulation induces Mueller's smooth muscle contraction in an isolated canine upper eyelid preparation.
    Current eye research, 2010
    Co-Authors: Shiharu Yano, Kiyoshi Matsuo, Masamichi Hirose, Tsutomu Nakada, Jun Nakayama, Mitsuhiko Yamada
    Abstract:

    Purpose: It has been demonstrated that in patients with Aponeurotic Blepharoptosis, α1-adrenoceptor stimulation causes the contraction of the upper eyelid tarsal smooth muscle (Mueller’s muscle) and opening of the eye. However, α1-adrenoceptor subtypes mediating the contraction of Mueller’s muscle are still unclear. This study was designed to identify the α1-adrenoceptor subtypes in Mueller’s muscle.Materials and Methods: A newly developed canine upper eyelid preparation was retrogradely perfused with a drug-containing Krebs-Henseleit solution through the angular vein in a temperature-controlled organ chamber. The contraction of the preparation was measured with a force-displacement transducer.Results: Phenylephrine, an α1-adrenoceptor agonist, increased the upper eyelid contractile force in a dose-dependent manner (K0.5 = 110 nmol). Interestingly, the contraction in response to phenylephrine was persistent and hardly recovered to a base line level for more than 100 min after washout of the drug. WB4101 (...

  • alternative etiology and surgical correction of acquired lower eyelid entropion
    Annals of Plastic Surgery, 2007
    Co-Authors: Kiyoshi Matsuo, Shunsuke Yuzuriha, Shiharu Yano, Iwao Narimatsu, Tatsuya Kawamura
    Abstract:

    When increased contraction of the levator muscle accompanied by the superior rectus muscle compensates for Aponeurotic Blepharoptosis, increased contraction of the inferior rectus muscle for foveation retracts the lower eyelid through the capsulopalpebral fascia, showing the lower sclera. We hypothesized that in patients with Aponeurotic Blepharoptosis, the capsulopalpebral fascia excessively retracts the posterior lamella of the lower eyelid alone while keeping the anterior lamella unretracted, especially in patients with both weak extension of the capsulopalpebral fascia to the pretarsal anterior lamella and increased contraction of the orbicularis oculi muscle, resulting in entropion. Aponeurotic reinsertion to the tarsus for the upper eyelid improved entropion in 15 younger patients. Surgical disinsertion of the capsulopalpebral fascia from the tarsus and creation of a cicatricial connection between the pretarsal skin and the tarsus for the lower eyelid corrected entropion in 15 elderly patients. Both procedures also corrected the lower scleral show.

Yasuhiro Takahashi - One of the best experts on this subject based on the ideXlab platform.

  • Usefulness of mirror image processing software for creating images of expected appearance after Blepharoptosis surgery
    International Ophthalmology, 2020
    Co-Authors: Yuki Mawatari, Takahiro Kawaji, Hirohiko Kakizaki, Aric Vaidya, Yasuhiro Takahashi
    Abstract:

    Purpose This study aims to evaluate the usefulness of creating images of expected appearance after Blepharoptosis surgery using mirror image processing software. Methods This prospective, observational study included 60 sides from 30 patients with bilateral Aponeurotic Blepharoptosis who underwent levator resection or Aponeurotic repair on both sides. Before surgery, facial photographs were taken after the eyelid on one side was lifted with a curved hook. The mirror images were created from these photographs and were merged with the original photographs for making the whole facial images, which were shown to each patient at the preoperative counseling. At 1 month postoperatively, we asked patients about the usefulness of the mirror images to predict the postoperative appearance at the preoperative counseling and the similarity between the expected and the resultant postoperative appearance using questionnaires. Margin reflex distance-1, eyebrow height, and pretarsal skin height measured on predictive images were compared with those measured at 1 month postoperatively. Results Twenty-nine patients (96.7%) favorably responded to the usefulness of the mirror images to predict the postoperative appearance, and twenty-five patients (83.3%) accepted the similarity between the expected appearance and the actual postoperative appearance. The predictive images showed significantly lower margin reflex distance-1, higher eyebrow height, and higher pretarsal skin height than the postoperative results ( P 

  • Surgical outcomes of the anterior versus posterior approach for advancement of the levator aponeurosis in Japanese patients.
    Journal of plastic reconstructive & aesthetic surgery : JPRAS, 2020
    Co-Authors: Hiromichi Matsuda, Yasuhiro Takahashi, Tsutomu Sakai, Tadashi Nakano
    Abstract:

    Summary Purpose To compare the surgical outcomes of the anterior and posterior approaches for advancement of the levator aponeurosis for Aponeurotic Blepharoptosis in relation to levator function (LF). Methods This retrospective study included 223 eyelids from 125 patients with Aponeurotic Blepharoptosis. The anterior approach was used for 115 eyelids from 65 patients (anterior group), while the posterior approach was used in 108 eyelids from 60 patients (posterior group). Patients were subdivided into two groups in accordance with their LF (fair: 5–10 mm; good: > 10 mm). Functional success was defined as a margin reflex distance of 2–5 mm without serious complications at 3 months postoperatively. Cosmetic success was defined as the achievement of ≤ 1 mm laterality of the upper eyelid height, ≤ 2 mm laterality of the pretarsal show, and eyelid contour symmetry at 3 months postoperatively. Results The functional success rates of the anterior and posterior groups were comparable for patients with good LF (78.9% vs 87.7%, p = 0.228), whereas it was better in the posterior group (85.7%) than the anterior group (64.1%) in the total group (p = 0.022) and in patients with fair LF (p = 0.031). The posterior group achieved better cosmetic success than the anterior group regarding upper eyelid height symmetry (p = 0.042) and pretarsal show (p = 0.012). No serious complications occurred during follow-up. Conclusions The posterior approach achieved better functional and cosmetic outcomes than the anterior approach, indicating that the posterior approach is more useful in patients with Aponeurotic Blepharoptosis, particularly for those with only fair LF.

  • Influence of epinephrine contained in local anesthetics on upper eyelid height in transconjunctival Blepharoptosis surgery
    Graefe's Archive for Clinical and Experimental Ophthalmology, 2020
    Co-Authors: Hiromichi Matsuda, Yasuhiro Takahashi, Yoshiaki Kabata, Yuri Hanzawa, Tadashi Nakano
    Abstract:

    Purpose To examine the influence of epinephrine contained in local anesthetic on upper eyelid height in transconjunctival Aponeurotic repair for Aponeurotic Blepharoptosis. Methods This retrospective study included 164 eyelids from 94 patients with Aponeurotic Blepharoptosis. Patients were divided according to the use of local anesthetic with (group A, n  = 108) or without 1:100000 epinephrine (group B, n  = 56). Margin reflex distance-1 (MRD-1) was measured before and after local anesthesia, and before, during, and 3 months after surgery. Change in MRD-1_a (∆MRD-1_a) was calculated by subtracting the postanesthetic MRD-1 value from the preanesthetic value, and we defined ∆MRD-1_b by subtracting the postoperative 3-month MRD-1 value from the intraoperative value. Results ∆MRD-1_a was positive in group A (0.57 ± 0.63 mm) and negative in group B (− 0.50 ± 0.45 mm; p  

  • Influence of fatty deposits in the levator aponeurosis/levator palpebrae superioris muscle on outcomes of Aponeurotic repair in a Japanese population
    Eye, 2018
    Co-Authors: Hiromichi Matsuda, Yasuhiro Takahashi, Tsutomu Sakai, Masaki Nakamura, Tadashi Nakano
    Abstract:

    Purpose To examine a part of the levator aponeurosis/levator palpebrae superioris (LPS) muscle that did not have fatty deposits in patients with Aponeurotic Blepharoptosis. We also analysed the relation between this length and surgical outcome after transcutaneous Aponeurotic repair. Methods We measured the vertical length from the distal end of the anterior layer of the levator aponeurosis to the most distal point of fatty deposits in the levator aponeurosis/LPS muscle (non-fatty-deposit length) in 94 eyelids. Surgical success was defined as a postoperative margin reflex distance-1 (MRD-1) of 2.0–5.0 mm at 3 months postoperatively. The eyelids were classified into two groups: a surgical success group (group A, 76 eyelids) and an undercorrected group (group B, 18 eyelids). Group A was subdivided according to the evidence of a fatty deposit (group A1, fat present, 70 eyelids; group A2, fat absent, 6 eyelids). Results The non-fatty-deposit measurement was significantly longer in group A1 than in group B ( p  = 0.035). The levator aponeurosis was less advanced in groups A1 and A2 than in group B (both, p  

  • Influence of fatty deposits in the levator aponeurosis/levator palpebrae superioris muscle on outcomes of Aponeurotic repair in a Japanese population.
    Eye (London England), 2018
    Co-Authors: Hiromichi Matsuda, Yasuhiro Takahashi, Tsutomu Sakai, Masaki Nakamura, Tadashi Nakano
    Abstract:

    To examine a part of the levator aponeurosis/levator palpebrae superioris (LPS) muscle that did not have fatty deposits in patients with Aponeurotic Blepharoptosis. We also analysed the relation between this length and surgical outcome after transcutaneous Aponeurotic repair. We measured the vertical length from the distal end of the anterior layer of the levator aponeurosis to the most distal point of fatty deposits in the levator aponeurosis/LPS muscle (non-fatty-deposit length) in 94 eyelids. Surgical success was defined as a postoperative margin reflex distance-1 (MRD-1) of 2.0–5.0 mm at 3 months postoperatively. The eyelids were classified into two groups: a surgical success group (group A, 76 eyelids) and an undercorrected group (group B, 18 eyelids). Group A was subdivided according to the evidence of a fatty deposit (group A1, fat present, 70 eyelids; group A2, fat absent, 6 eyelids). The non-fatty-deposit measurement was significantly longer in group A1 than in group B (p = 0.035). The levator aponeurosis was less advanced in groups A1 and A2 than in group B (both, p 

Shunsuke Yuzuriha - One of the best experts on this subject based on the ideXlab platform.

  • A Contractile Network of Interstitial Cells of Cajal in the Supratarsal Mueller's Smooth Muscle Fibers With Sparse Sympathetic Innervation.
    Eplasty, 2012
    Co-Authors: Shunsuke Yuzuriha, Kiyoshi Matsuo, Ryokuya Ban, Shiharu Yano, Tetsuji Moriizumi
    Abstract:

    Mueller's smooth muscle fibers are serially located between the levator muscle fibers and the tarsus, under the levator aponeurosis; we have previously reported that Mueller's smooth muscle fibers are innervated by unmyelinated sympathetic efferent fibers, and furthermore, that the intramuscular connective tissues interspersed among the smooth muscle fibers are innervated by myelinated trigeminal proprioceptive afferent fibers (Fig ​(Fig11a).1,2 The latter fibers function as mechanoreceptors, inducing reflexive contraction of 2 different eyelid-opening muscles, the levator and frontalis muscles. Voluntary contraction of the levator fast-twitch muscle fibers stretches the mechanoreceptors in Mueller's muscle to evoke trigeminal proprioception, thereby stimulating both the oculomotor neurons and the frontalis motoneurons to induce reflexive contraction of the levator and frontalis slow-twitch muscle fibers, respectively. This results in involuntary continuous lifting of the eyelid and eyebrow to maintain a visual field corresponding to changes in vertical gaze as a type of length servomechanism.3-9 Figure 1 A neurophysiological schema involuntarily maintains an adequate visual field by reflexive contraction of the levator and frontalis slow-twitch fibers during changes in vertical gaze as a type of length servomechanism. (a) Normal condition. (b) Aponeurotic ... Aponeurotic Blepharoptosis is caused by disinsertion of the levator aponeurosis from the tarsus and elongated attenuation of the levator aponeurosis and underlying Mueller's muscle (Figs ​(Figs1b1b and ​and22a).10-12 During eyelid opening in patients with Aponeurotic Blepharoptosis, the retractile force of the levator muscle is transmitted to the tarsus via the sympathetically innervated Mueller's muscle instead of the aponeurosis. It has been empirically noted that the eye will open quite normally despite total disconnection of the aponeurosis, as long as there is a normally functioning Mueller's muscle.13 Therefore, in patients with Aponeurotic Blepharoptosis, stretching of Mueller's muscle must induce contraction of Mueller's smooth muscle fibers for transmission of the retractile force from the levator muscle to the tarsus. Figure 2 Changes in the upper eyelid retraction distance (UERD) before and after phenylephrine-mediated contraction of the posterior Mueller's muscle that faces the conjunctiva palpebrae. (a) A 58-year-old woman with Aponeurotic Blepharoptosis prior to administration ... As controversy persists around the identity and physiological roles of the mechanoreceptor in Mueller's muscle, we sought to clinically and histologically investigate Mueller's muscle.

  • alternative etiology and surgical correction of acquired lower eyelid entropion
    Annals of Plastic Surgery, 2007
    Co-Authors: Kiyoshi Matsuo, Shunsuke Yuzuriha, Shiharu Yano, Iwao Narimatsu, Tatsuya Kawamura
    Abstract:

    When increased contraction of the levator muscle accompanied by the superior rectus muscle compensates for Aponeurotic Blepharoptosis, increased contraction of the inferior rectus muscle for foveation retracts the lower eyelid through the capsulopalpebral fascia, showing the lower sclera. We hypothesized that in patients with Aponeurotic Blepharoptosis, the capsulopalpebral fascia excessively retracts the posterior lamella of the lower eyelid alone while keeping the anterior lamella unretracted, especially in patients with both weak extension of the capsulopalpebral fascia to the pretarsal anterior lamella and increased contraction of the orbicularis oculi muscle, resulting in entropion. Aponeurotic reinsertion to the tarsus for the upper eyelid improved entropion in 15 younger patients. Surgical disinsertion of the capsulopalpebral fascia from the tarsus and creation of a cicatricial connection between the pretarsal skin and the tarsus for the lower eyelid corrected entropion in 15 elderly patients. Both procedures also corrected the lower scleral show.

  • Pathogenesis and surgical correction of involuntary contraction of the occipitofrontalis muscle that causes forehead wrinkles.
    Annals of plastic surgery, 2006
    Co-Authors: Shoji Kondoh, Kiyoshi Matsuo, Niroh Kikuchi, Shunsuke Yuzuriha
    Abstract:

    Assuming that an agonistic function is present to maintain an adequate visual field, we hypothesized that stretching of the mechanoreceptor of Mueller muscle induces involuntary contraction of the occipitofrontalis muscle, as well as the levator muscles. In patients with Aponeurotic Blepharoptosis, both unilateral instillation of phenylephrine to contact Mueller smooth muscle fibers and unilateral Aponeurotic fixation ipsilaterally reduced the eyebrow height during primary and upward gazing. Bilateral Aponeurotic fixation bilaterally reduced the eyebrow height, with fewer forehead wrinkles. Stretching of the mechanoreceptor of Mueller muscle induces involuntary contraction of the bilateral levator muscles. Its increased stretching may induce involuntary contraction of the ipsilateral occipitofrontalis muscle via the mesencephalic trigeminal nucleus and the facial subnucleus as another stretch reflex. The involuntary contraction of the occipitofrontalis muscle that causes forehead wrinkles during primary gazing can be corrected by the Aponeurotic fixation to reduce the stretching of Mueller muscle.

  • Upgaze eyelid position allows differentiation between congenital and Aponeurotic Blepharoptosis according to the neurophysiology of eyelid retraction.
    Annals of plastic surgery, 2006
    Co-Authors: Chihiro Hirasawa, Kiyoshi Matsuo, Niroh Kikuchi, Yoshiroh Osada, Hiroshi Shinohara, Shunsuke Yuzuriha
    Abstract:

    Abstract:To differentiate between congenital and Aponeurotic Blepharoptosis, we investigated whether upgaze with stretching of the mechanoreceptor of Mueller muscle increases involuntary reflex contraction of the levator slow-twitch muscle fibers.In 50 cases each of unilateral congenital blepharopto

  • Etiology and pathogenesis of Aponeurotic Blepharoptosis.
    Annals of plastic surgery, 2001
    Co-Authors: Takeshi Fujiwara, Kiyoshi Matsuo, Shouji Kondoh, Shunsuke Yuzuriha
    Abstract:

    How and why Aponeurotic Blepharoptosis develops was investigated in terms of the relationship between the levator aponeurosis and Mueller's muscle functioning as the muscle spindle of the levator muscle. A total of 200 consecutive patients with moderate to severe acquired Blepharoptosis completed questionnaires regarding their history of physical irritations to the eyelids, and intraoperative conditions of the levator aponeurosis and Mueller's muscle were evaluated. Several kinds of physical irritations to the eyelids were reported, such as habitual rubbing of the eyelids, contact lens usage, cataract surgery, and continuous rubbing of the eyelids while crying all night. The two main findings for aponeurosis were that it was disinserted from the tarsus, resulting in a large amount of play between the aponeurosis and the tarsus, and that the aponeurosis and Mueller's muscle were attenuated and elongated. The authors believe that rubbing may have caused disinsertion as well as attenuation and elongation of the aponeurosis, which result in transmission failures between the levator muscle and the tarsus as well as between the levator muscle and the mechanoreceptor of Mueller's muscle, leading to clinical Blepharoptosis.

Tadashi Nakano - One of the best experts on this subject based on the ideXlab platform.

  • Surgical outcomes of the anterior versus posterior approach for advancement of the levator aponeurosis in Japanese patients.
    Journal of plastic reconstructive & aesthetic surgery : JPRAS, 2020
    Co-Authors: Hiromichi Matsuda, Yasuhiro Takahashi, Tsutomu Sakai, Tadashi Nakano
    Abstract:

    Summary Purpose To compare the surgical outcomes of the anterior and posterior approaches for advancement of the levator aponeurosis for Aponeurotic Blepharoptosis in relation to levator function (LF). Methods This retrospective study included 223 eyelids from 125 patients with Aponeurotic Blepharoptosis. The anterior approach was used for 115 eyelids from 65 patients (anterior group), while the posterior approach was used in 108 eyelids from 60 patients (posterior group). Patients were subdivided into two groups in accordance with their LF (fair: 5–10 mm; good: > 10 mm). Functional success was defined as a margin reflex distance of 2–5 mm without serious complications at 3 months postoperatively. Cosmetic success was defined as the achievement of ≤ 1 mm laterality of the upper eyelid height, ≤ 2 mm laterality of the pretarsal show, and eyelid contour symmetry at 3 months postoperatively. Results The functional success rates of the anterior and posterior groups were comparable for patients with good LF (78.9% vs 87.7%, p = 0.228), whereas it was better in the posterior group (85.7%) than the anterior group (64.1%) in the total group (p = 0.022) and in patients with fair LF (p = 0.031). The posterior group achieved better cosmetic success than the anterior group regarding upper eyelid height symmetry (p = 0.042) and pretarsal show (p = 0.012). No serious complications occurred during follow-up. Conclusions The posterior approach achieved better functional and cosmetic outcomes than the anterior approach, indicating that the posterior approach is more useful in patients with Aponeurotic Blepharoptosis, particularly for those with only fair LF.

  • Influence of epinephrine contained in local anesthetics on upper eyelid height in transconjunctival Blepharoptosis surgery
    Graefe's Archive for Clinical and Experimental Ophthalmology, 2020
    Co-Authors: Hiromichi Matsuda, Yasuhiro Takahashi, Yoshiaki Kabata, Yuri Hanzawa, Tadashi Nakano
    Abstract:

    Purpose To examine the influence of epinephrine contained in local anesthetic on upper eyelid height in transconjunctival Aponeurotic repair for Aponeurotic Blepharoptosis. Methods This retrospective study included 164 eyelids from 94 patients with Aponeurotic Blepharoptosis. Patients were divided according to the use of local anesthetic with (group A, n  = 108) or without 1:100000 epinephrine (group B, n  = 56). Margin reflex distance-1 (MRD-1) was measured before and after local anesthesia, and before, during, and 3 months after surgery. Change in MRD-1_a (∆MRD-1_a) was calculated by subtracting the postanesthetic MRD-1 value from the preanesthetic value, and we defined ∆MRD-1_b by subtracting the postoperative 3-month MRD-1 value from the intraoperative value. Results ∆MRD-1_a was positive in group A (0.57 ± 0.63 mm) and negative in group B (− 0.50 ± 0.45 mm; p  

  • Influence of fatty deposits in the levator aponeurosis/levator palpebrae superioris muscle on outcomes of Aponeurotic repair in a Japanese population
    Eye, 2018
    Co-Authors: Hiromichi Matsuda, Yasuhiro Takahashi, Tsutomu Sakai, Masaki Nakamura, Tadashi Nakano
    Abstract:

    Purpose To examine a part of the levator aponeurosis/levator palpebrae superioris (LPS) muscle that did not have fatty deposits in patients with Aponeurotic Blepharoptosis. We also analysed the relation between this length and surgical outcome after transcutaneous Aponeurotic repair. Methods We measured the vertical length from the distal end of the anterior layer of the levator aponeurosis to the most distal point of fatty deposits in the levator aponeurosis/LPS muscle (non-fatty-deposit length) in 94 eyelids. Surgical success was defined as a postoperative margin reflex distance-1 (MRD-1) of 2.0–5.0 mm at 3 months postoperatively. The eyelids were classified into two groups: a surgical success group (group A, 76 eyelids) and an undercorrected group (group B, 18 eyelids). Group A was subdivided according to the evidence of a fatty deposit (group A1, fat present, 70 eyelids; group A2, fat absent, 6 eyelids). Results The non-fatty-deposit measurement was significantly longer in group A1 than in group B ( p  = 0.035). The levator aponeurosis was less advanced in groups A1 and A2 than in group B (both, p  

  • Influence of fatty deposits in the levator aponeurosis/levator palpebrae superioris muscle on outcomes of Aponeurotic repair in a Japanese population.
    Eye (London England), 2018
    Co-Authors: Hiromichi Matsuda, Yasuhiro Takahashi, Tsutomu Sakai, Masaki Nakamura, Tadashi Nakano
    Abstract:

    To examine a part of the levator aponeurosis/levator palpebrae superioris (LPS) muscle that did not have fatty deposits in patients with Aponeurotic Blepharoptosis. We also analysed the relation between this length and surgical outcome after transcutaneous Aponeurotic repair. We measured the vertical length from the distal end of the anterior layer of the levator aponeurosis to the most distal point of fatty deposits in the levator aponeurosis/LPS muscle (non-fatty-deposit length) in 94 eyelids. Surgical success was defined as a postoperative margin reflex distance-1 (MRD-1) of 2.0–5.0 mm at 3 months postoperatively. The eyelids were classified into two groups: a surgical success group (group A, 76 eyelids) and an undercorrected group (group B, 18 eyelids). Group A was subdivided according to the evidence of a fatty deposit (group A1, fat present, 70 eyelids; group A2, fat absent, 6 eyelids). The non-fatty-deposit measurement was significantly longer in group A1 than in group B (p = 0.035). The levator aponeurosis was less advanced in groups A1 and A2 than in group B (both, p 

Hiromichi Matsuda - One of the best experts on this subject based on the ideXlab platform.

  • Surgical outcomes of the anterior versus posterior approach for advancement of the levator aponeurosis in Japanese patients.
    Journal of plastic reconstructive & aesthetic surgery : JPRAS, 2020
    Co-Authors: Hiromichi Matsuda, Yasuhiro Takahashi, Tsutomu Sakai, Tadashi Nakano
    Abstract:

    Summary Purpose To compare the surgical outcomes of the anterior and posterior approaches for advancement of the levator aponeurosis for Aponeurotic Blepharoptosis in relation to levator function (LF). Methods This retrospective study included 223 eyelids from 125 patients with Aponeurotic Blepharoptosis. The anterior approach was used for 115 eyelids from 65 patients (anterior group), while the posterior approach was used in 108 eyelids from 60 patients (posterior group). Patients were subdivided into two groups in accordance with their LF (fair: 5–10 mm; good: > 10 mm). Functional success was defined as a margin reflex distance of 2–5 mm without serious complications at 3 months postoperatively. Cosmetic success was defined as the achievement of ≤ 1 mm laterality of the upper eyelid height, ≤ 2 mm laterality of the pretarsal show, and eyelid contour symmetry at 3 months postoperatively. Results The functional success rates of the anterior and posterior groups were comparable for patients with good LF (78.9% vs 87.7%, p = 0.228), whereas it was better in the posterior group (85.7%) than the anterior group (64.1%) in the total group (p = 0.022) and in patients with fair LF (p = 0.031). The posterior group achieved better cosmetic success than the anterior group regarding upper eyelid height symmetry (p = 0.042) and pretarsal show (p = 0.012). No serious complications occurred during follow-up. Conclusions The posterior approach achieved better functional and cosmetic outcomes than the anterior approach, indicating that the posterior approach is more useful in patients with Aponeurotic Blepharoptosis, particularly for those with only fair LF.

  • Influence of epinephrine contained in local anesthetics on upper eyelid height in transconjunctival Blepharoptosis surgery
    Graefe's Archive for Clinical and Experimental Ophthalmology, 2020
    Co-Authors: Hiromichi Matsuda, Yasuhiro Takahashi, Yoshiaki Kabata, Yuri Hanzawa, Tadashi Nakano
    Abstract:

    Purpose To examine the influence of epinephrine contained in local anesthetic on upper eyelid height in transconjunctival Aponeurotic repair for Aponeurotic Blepharoptosis. Methods This retrospective study included 164 eyelids from 94 patients with Aponeurotic Blepharoptosis. Patients were divided according to the use of local anesthetic with (group A, n  = 108) or without 1:100000 epinephrine (group B, n  = 56). Margin reflex distance-1 (MRD-1) was measured before and after local anesthesia, and before, during, and 3 months after surgery. Change in MRD-1_a (∆MRD-1_a) was calculated by subtracting the postanesthetic MRD-1 value from the preanesthetic value, and we defined ∆MRD-1_b by subtracting the postoperative 3-month MRD-1 value from the intraoperative value. Results ∆MRD-1_a was positive in group A (0.57 ± 0.63 mm) and negative in group B (− 0.50 ± 0.45 mm; p  

  • Influence of fatty deposits in the levator aponeurosis/levator palpebrae superioris muscle on outcomes of Aponeurotic repair in a Japanese population
    Eye, 2018
    Co-Authors: Hiromichi Matsuda, Yasuhiro Takahashi, Tsutomu Sakai, Masaki Nakamura, Tadashi Nakano
    Abstract:

    Purpose To examine a part of the levator aponeurosis/levator palpebrae superioris (LPS) muscle that did not have fatty deposits in patients with Aponeurotic Blepharoptosis. We also analysed the relation between this length and surgical outcome after transcutaneous Aponeurotic repair. Methods We measured the vertical length from the distal end of the anterior layer of the levator aponeurosis to the most distal point of fatty deposits in the levator aponeurosis/LPS muscle (non-fatty-deposit length) in 94 eyelids. Surgical success was defined as a postoperative margin reflex distance-1 (MRD-1) of 2.0–5.0 mm at 3 months postoperatively. The eyelids were classified into two groups: a surgical success group (group A, 76 eyelids) and an undercorrected group (group B, 18 eyelids). Group A was subdivided according to the evidence of a fatty deposit (group A1, fat present, 70 eyelids; group A2, fat absent, 6 eyelids). Results The non-fatty-deposit measurement was significantly longer in group A1 than in group B ( p  = 0.035). The levator aponeurosis was less advanced in groups A1 and A2 than in group B (both, p  

  • Influence of fatty deposits in the levator aponeurosis/levator palpebrae superioris muscle on outcomes of Aponeurotic repair in a Japanese population.
    Eye (London England), 2018
    Co-Authors: Hiromichi Matsuda, Yasuhiro Takahashi, Tsutomu Sakai, Masaki Nakamura, Tadashi Nakano
    Abstract:

    To examine a part of the levator aponeurosis/levator palpebrae superioris (LPS) muscle that did not have fatty deposits in patients with Aponeurotic Blepharoptosis. We also analysed the relation between this length and surgical outcome after transcutaneous Aponeurotic repair. We measured the vertical length from the distal end of the anterior layer of the levator aponeurosis to the most distal point of fatty deposits in the levator aponeurosis/LPS muscle (non-fatty-deposit length) in 94 eyelids. Surgical success was defined as a postoperative margin reflex distance-1 (MRD-1) of 2.0–5.0 mm at 3 months postoperatively. The eyelids were classified into two groups: a surgical success group (group A, 76 eyelids) and an undercorrected group (group B, 18 eyelids). Group A was subdivided according to the evidence of a fatty deposit (group A1, fat present, 70 eyelids; group A2, fat absent, 6 eyelids). The non-fatty-deposit measurement was significantly longer in group A1 than in group B (p = 0.035). The levator aponeurosis was less advanced in groups A1 and A2 than in group B (both, p 

  • Transcutaneous Aponeurotic repair with small detachment of the levator aponeurosis for Aponeurotic Blepharoptosis in Japanese patients
    Journal of plastic reconstructive & aesthetic surgery : JPRAS, 2017
    Co-Authors: Hiromichi Matsuda, Takuya Shiba, Yasuhiro Takahashi, Hiroshi Tsuneoka
    Abstract:

    Summary Purpose To examine the surgical outcomes of a modified transcutaneous Aponeurotic repair for Aponeurotic Blepharoptosis in a Japanese population. Methods This retrospective study included 75 eyelids of 45 patients with Aponeurotic Blepharoptosis who had undergone a modified transcutaneous Aponeurotic repair. This procedure included a long skin incision for securing a wide surgical field, creation of a double eyelid crease, and a small extent of detachment of the levator aponeurosis from the tarsal surface. Functional success was defined as a postoperative margin reflex distance-1 of 2–5 mm without serious complications at 3 months postoperatively. Cosmetic success was judged by achieving a ≤ 1-mm laterality of eyelid height, a ≤ 2-mm laterality of pretarsal show, and symmetry of the eyelid contour at 3 months postoperatively. Results The functional success rate was 70.7% among all patients, with 84.4%, 86.7%, and 88.9% of patients showing cosmetic success regarding symmetry of eyelid height, pretarsal show, and eyelid contour, respectively. After applying functional and all 3 cosmetic criteria simultaneously, 28 patients (62.2%) were satisfied in this study. No serious complications occurred during the follow-up period. Conclusions This modified procedure provided good functional and cosmetic outcomes for Aponeurotic Blepharoptosis, indicating an acceptable Blepharoptosis repair for East Asian patients.