Study finds, Long-term Results of Palpebral Fissure Transfer
A Study was conducted to evaluate the long-term outcomes of the palpebral fissure transfer (PFT) technique without lower eyelid spacer in chronic progressive external ophthalmoplegia (CPEO).

Consecutive CPEO patients with PFT surgery and a minimum follow up of 24 months were included. The PFT included simultaneous levator resection or frontalis sling and lower eyelid retractor recession without spacer. Primary outcome measures comprised the change in margin reflex distance 1 (MRD-1), MRD-2, and palpebral fissure height (PFH) in the course of time. Potential predictors of keratopathy were also explored.

--There were 32 patients with the mean age and follow up of 34.1 years and 37.9 months, respectively.

--Mean MRD-1 significantly increased from -0.9 mm to 3.4 mm in the postoperative week 1-2 and 1.8 mm at the last follow up.

--Mean MRD-2 significantly decreased from 5.6 mm to 3.7 mm in the postoperative week 1-2 and 5 mm at the last follow up.

--Eyes with frank lower eyelid retraction (MRD-2 more than 5 mm) gained more reduction in MRD-2 compared to those with no sclera show (-0.9 mm vs. -0.3 mm).

--Re-operation was performed in 9 eyelids for under- (5) and over-correction (4). Persistent keratopathy was observed in 3 eyes (4.5%).

Finally, lower eyelid retractor recession without a spacer results in significant corneal protection during the critical early postoperative period, when the risk of keratopathy is greatest.