Response to Letter: Upper eyelid platinum weight placement for the treatment of paralytic lagophthalmos: A new plane between the inner septum and the levator aponeurosis

Article information

Arch Plast Surg. 2018;45(6):598-599

Publication date (electronic) : 2018 November 15

doi : https://doi.org/10.5999/aps.2018.01207

Tae Suk Oh, Kyunghyun Min, Sin Young Song, Jong Woo Choi, Kyung Suk Koh

Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Correspondence: Tae Suk Oh Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3607, Fax: +82-2-476-7471, E-mail: tasuko@amc.seoul.kr

The article was presented at PRS Korea 2015 on November 13-15, 2015 in Seoul, Korea.

Received 2018 October 15; Revised 2018 October 20; Accepted 2018 October 20.

First, I would like to thank you for your interest in and comments on our paper.

In your study, it is stated that “the levator aponeurosis was dissected free from the anterior tarsal surface.” We think that this statement is ambiguous, and interpreted it as indicating that sufficient dissection was performed to fix the gold weight to the levator aponeurosis. It seems that this would require wide dissection, which may lead to unintentional damage to the levator aponeurosis or adjacent tissue. Moreover, the space between the preaponeurotic space and the levator aponeurosis would be very narrow for suture fixation of the uppermost central portion of the levator aponeurosis to the gold weight, and as a result, this could be a traumatic procedure.

In contrast, we performed minimally invasive slit dissection through the tarsal plate to fix the tarsal plate instead of releasing the levator. The width and height of the plate were accurately measured, and the pocket was made and inserted according to the measurements. We also did not fix the uppermost portion of the weight because we created the pocket correctly. Therefore, the plane and the fixation procedure both seem to be different from those described in your study.

Thank you.

Notes

No potential conflict of interest relevant to this article was reported.

Article information Continued

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.