Title: Management of Moderate to Severe Marcus Gunn Syndrome by Levator Disinsertion and Frontalis Sling of Affected Eye

Authors: Dr (Prof) P.Rawat, Dr Awani Dubey, Dr Shikha Kudape, Dr Upali Tiwari

 DOI: https://dx.doi.org/10.18535/jmscr/v8i5.30

Abstract

 

Purpose: To describe the treatment of Marcus gunn jaw winking ptosis by levator disinsertion and silicone sling surgery

Methods: A 12-year old female patient presented with drooping of left upper lid since birth with defective vision. She had a mild chin elevation.

In this case, levator muscle was disinserted and the eyelid was coupled to the frontalis muscle using a sling made of a synthetic material. By recruiting the frontalis muscle to raise the eyelids, this procedure relieved the dysfunctional levator from contributing to eyelid elevation.

Results: Following surgery, the lid lag, which was quite marked at the beginning, was much reduced after three months. The lagophthalmos was minimal. A good symmetrical lift with a good lid fold was obtained. There were no post-operative complications like suture abcess, overcorrection or under correction
Conclusions: Surgical treatment of mild to moderate marcusgunn jaw winking ptosis could be done with affected eye levator disinsertion with frontalis sling surgery rather than operating on both eyes.

References

  1. Ptosis surgery –Dr Arnab Biswas
  2. Davis G, Chen C, Selva D. Macus Gunn syndrome. Eye. 2004; 18:88.
  3. Bowyer JD, Sullivan TJ. Management of Marcus Gunn jaw winking synkinesis. Ophthal Plast Reconstr Surg. 2004; 20:92

Corresponding Author

Dr Awani Dubey

Resident Doctor, Department of Ophthalmology, Mahatma Gandhi Memorial Medical College, M.Y. Hospital Indore (M.P.) 452001, India