Latest advancement in blepharophimosis surgery in India

Latest Advancement In Blepharophimosis Surgery In India
Blepharophimosis or BPES syndrome is characterised by malformations in the eyelid and four key features namely blepharophimsis, ptosis, as well
as epicanthus inversus and telecanthus. These specific features give the syndrome its defining symptoms, whereby the bridge of the nose is flat
and patients also have a hypoplastic orbital rim. BPES syndrome was first discovered as dysplasia of the eyelids as well as vision problems such as
lazy eyes and strabismus.
Wide Array of Tests for BPES
The latest advancements in blepharophimosis surgery in India have seen a wide array of tests come to the fore for treating this syndrome.
Endocrinology results for hypergonadotropic hypogonadism involve a test for high serum concentrate of FSH and luteinising hormones. This shows
low serum amounts of estradiol and progestrone. Ultrasound examinations are also carried out. Treatment of this condition involves a multifaceted team of specialists including geneticists, oculoplastic surgeons, endocrinologists and gynaecologists. Surgery now involves medial
canthoplasty for rectifying the damage caused at ages 3-5 due to telecanthus , epicanthus and blepharophimosis. Ptosis correction follows to
correct brow suspension.
Progressive Surgery for BPES
Telecanthus is also surgically treated through reduction of the medial canthal tendon with a transnasal wire.For treatment of epicanthus, a Y-V
traditional canthoplasty ma also be performed if folds are not large enough. If they are, a double Z canthoplasty is performed. HRT also helps in
countering women suffering from ovarian insufficiency.
Advances in Understanding of Aetiology
FOXL2 is the gene associated with BPES. This gene is responsible for the production of the FOXL2 protein known to be involved in the muscle
development of the eyelid as well as growth and development of ovarian cells. Mutations in this gene result in syndrome related symptoms
stemming in an autosomal dominant manner. Differential diagnosis of BPES also requires the correct skills on part of the clinician. Correct diagnosis
based on the four clinical manifestations is a must. In blepharophimosis, the dropping of the upper eyelid, skin gold in the lower eyelid and wide
set eyes along with narrowing eyelids at birth forms a basis of a definitive diagnosis. Clinical signs blepharophimosis surgery that may be needed
include elevated serum levels of LH ad FSH and low levels of progesterone and estradiol. Several genetic tests may also be carried out such as
molecular genetic testing of FOXL2, sequence and duplication analysis and chromosome analysis.
Surgical treatment corrects the four clinical abnormalities associated with this disease. In India, surgical procedures have advanced with technology
and new knowledge about the factors implicated in the aetiology of this disease. Currently, surgical treatment is carried out in India by oculoplastic
surgeons with assistance as and when necessary from other specialists. Repair of ptosis is generally undertaken first, followed by canthal repair.
The surgery for blepharophimosis involves careful and detailed inputs using advanced analysis. Success of blepharophimosis surgery in India has
greatly improved with well-established clinics offering extensive facilities and amenities to solve the symptoms and malformations associated with
blepharophimosis to enable individuals to lead a normal life and routine.
About the Author: is a unique website started by top Oculoplastic Surgeon, Dr. Debraj Shome. This is a patient information
tool on oculoplasty, Lacrimal surgery, eyelid surgery and orbital surgery. Dr. Debraj Shome is one of the world's best surgeons, super specialized
in Eyelid Surgery and facial plastic surgery. He started the Esthetic clinics, which are a chain of multiple centers located in Mumbai, India. Dr. Shome
is trained from the best centers in the world in aesthetic facial plastic surgery.
Contact Details:
Contact Person: Dr. Akshay Mhatre,
Designation: Manager
Address: Oculoplastic Eyelid Orbit Surgery
Apollo Spectra Hospital (earlier Nova Specialty Surgery Hospital)
Sunder Baug, Ujagar Compound,
Opp. Deonar Bus Depot Main Gate,
Off. Sion–Trombay Road, Deonar,
Chembur, Mumbai, Maharashtra – 400088
Working Hours: 9 AM - 6 PM
Phone: +91-9619610388
Email: [email protected]
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