{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T07:00:08Z","timestamp":1784012408203,"version":"3.55.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,1,5]],"date-time":"2021-01-05T00:00:00Z","timestamp":1609804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007225","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["109-2314-B-037-020-MY3"],"award-info":[{"award-number":["109-2314-B-037-020-MY3"]}],"id":[{"id":"10.13039\/100007225","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004694","name":"Kaohsiung Medical University","doi-asserted-by":"publisher","award":["KMU-TC108A02-5"],"award-info":[{"award-number":["KMU-TC108A02-5"]}],"id":[{"id":"10.13039\/501100004694","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004694","name":"Kaohsiung Medical University","doi-asserted-by":"publisher","award":["KMUH109-9R30"],"award-info":[{"award-number":["KMUH109-9R30"]}],"id":[{"id":"10.13039\/501100004694","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Severe blepharoptosis with poor levator function (LF) has traditionally been managed with exogenous frontalis suspension but complications such as lagophthalmos, infection, and rejection are often reported.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The aim of this study was to design a function-preserving frontalis orbicularis oculi muscle (FOOM) flap to correct severe blepharoptosis with poor LF. The long-term surgical outcome of the technique was assessed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This retrospective study included only adult patients with severe blepharoptosis and poor LF, all of whom had their surgery performed by the senior surgeon over a 6-year period. Clinical assessment of LF, palpebral fissure height (PFH), marginal reflex distance 1 (MRD1), duration of follow-up, and postoperative complications were recorded.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 34 patients and 59 eyelids were recorded during a mean follow-up period of 17.7 months. Postoperative evaluation yielded mean [standard deviation] improvements of PFH gain of 5.62 [1.61] mm (P &amp;lt; 0.001), and MRD1 and PFH increases of 4.03 [0.82] mm (P &amp;lt; 0.001) and 8.94 [0.81] mm (P &amp;lt; 0.001), respectively. All patients demonstrated normalization of orbicularis function: no lagophthalmos was observed at the 8-month postoperative follow-up. Recurrence of ptosis was recorded in 4 eyelids (6.78%). Revisions were performed in 2 eyelids (3.39%). No infection or granuloma was noted.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The function-preserving FOOM flap is a useful vector for frontalis suspension. Not only does it effectively address lagophthalmos as well as other complications, but it provides aesthetically pleasing outcomes in patients with severe blepharoptosis and poor LF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Level of Evidence: 4<\/jats:title>\n                  <jats:p\/>\n               <\/jats:sec>","DOI":"10.1093\/asj\/sjaa429","type":"journal-article","created":{"date-parts":[[2021,1,10]],"date-time":"2021-01-10T02:37:22Z","timestamp":1610246242000},"page":"NP260-NP266","source":"Crossref","is-referenced-by-count":15,"title":["The Function-Preserving Frontalis Orbicularis Oculi Muscle Flap for the Correction of Severe Blepharoptosis With Poor Levator Function"],"prefix":"10.1093","volume":"41","author":[{"given":"Shu-Hung","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Surgery, Kaohsiung Medical University Hospital , Kaohsiung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Chen","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kaohsiung Medical University Hospital , Kaohsiung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsin-Ti","family":"Lai","sequence":"additional","affiliation":[{"name":"Director of the International Aesthetic Medical Center, Park One International Hospital , Kaohsiung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidenobu","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kaohsiung Medical University Hospital , Kaohsiung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Chi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kaohsiung Medical University Hospital , Kaohsiung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung-Sheng","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kaohsiung Medical University Hospital , Kaohsiung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,1,5]]},"reference":[{"issue":"5","key":"2024083110010996200_CIT0001","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/00055735-199410000-00013","article-title":"Blepharoplasty and ptosis","volume":"5","author":"Hague","year":"1994","journal-title":"Curr Opin Ophthalmol."},{"issue":"8","key":"2024083110010996200_CIT0002","doi-asserted-by":"crossref","first-page":"NP269","DOI":"10.1093\/asj\/sjv249","article-title":"Aesthetic plastic surgery in Asians: principles and techniques","volume":"36","author":"Ishii","year":"2016","journal-title":"Aesth Surg J"},{"issue":"3","key":"2024083110010996200_CIT0003","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/s00266-003-0127-5","article-title":"Ptosis: causes, presentation, and management","volume":"27","author":"Finsterer","year":"2003","journal-title":"Aesthetic Plast Surg."},{"issue":"2","key":"2024083110010996200_CIT0004","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1097\/00001665-200603000-00008","article-title":"Palpebral ptosis: clinical classification, differential diagnosis, and surgical guidelines: an overview","volume":"17","author":"Clauser","year":"2006","journal-title":"J Craniofac Surg."},{"issue":"8","key":"2024083110010996200_CIT0005","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1016\/S0161-6420(91)32150-X","article-title":"Congenital ptosis. 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