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Wang Y, Wu Q, Li L, Liu W, Li C, Fan Y, Cao W, Li N. A modified Fox pentagon technique performed using a polytetrafluoroethylene sling in frontalis suspension to treat blepharophimosis syndrome. Sci Prog 2020; 103:36850419893880. [PMID: 32008456 PMCID: PMC10452787 DOI: 10.1177/0036850419893880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to evaluate the functional and cosmetic outcomes of a new modified Fox pentagon technique performed using polytetrafluoroethylene in frontalis suspension surgery for blepharophimosis syndrome. This retrospective study enrolled 40 patients diagnosed with blepharophimosis syndrome from March 2016 to October 2018. All patients underwent frontalis suspension using a new modified Fox pentagon technique. The functional and cosmetic outcomes were evaluated. After the operation, the mean palpebral fissure height increased from 2.68 to 6.93 in right eyes and from 2.73 to 6.98 in left eyes. The mean MRD1 increased from 0.53 to 3.76 in right eyes and from 0.50 to 3.78 in left eyes. While preoperative to postoperative differences were statistically significant (p < 0.01), there were no significant differences between right and left eyes either before or after the surgery (p > 0.01). All patients achieved good cosmetic results with an average score of 0.6. We have experimentally created a modified Fox pentagon technique performed using a polytetrafluoroethylene sling in a frontalis suspension to treat BPES; this approach yielded favorable cosmetic and functional outcomes.
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Affiliation(s)
- Yuan Wang
- Department of Ophthalmology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Qian Wu
- Department of Ophthalmology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Li Li
- Department of Ophthalmology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Wen Liu
- Department of Ophthalmology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Cheng Li
- Department of Ophthalmology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Yunwei Fan
- Department of Ophthalmology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - WenHong Cao
- Department of Ophthalmology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
| | - Ningdong Li
- Department of Ophthalmology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing, China
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Lin B, Zeng B, Zhao J, Xu T, Wang Y, Hu B, Li F, Zhao Q, Liu R, Liu J, Chen JM, Huang D, Wang Y. Seven Novel and Three Known Mutations in FOXL2 in 10 Chinese Families with Blepharophimosis Syndrome. Curr Mol Med 2019; 18:152-159. [PMID: 30198434 DOI: 10.2174/1566524018666180907162619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 07/22/2018] [Accepted: 09/05/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Blepharophimosis syndrome (BPES) is characterized by eyelid malformation with occasional premature ovarian failure. Mutations in FOXL2 underlie a fraction of BPES cases. OBJECTIVE We aimed to investigate the genetic basis of BPES in 26 Chinese families that included 78 patients. METHODS We performed ophthalmological examinations on each family member. We used Sanger sequencing to screen FOXL2 exons and their flanking sequences. We also performed bioinformatics studies, structural modeling and pathogenicity evaluations on all identified variations. Literature was reviewed and genotype-phenotype correlation analysis was performed. RESULTS The patients had typical manifestations of BPES. Ten mutations were identified in ten of the twenty-six families. Among these, seven were novel mutations. These included the six truncating mutations, p.Glu69*, p.Gly256Glyfs*14, p.Ala14Serfs*135, p.Pro333Profs*200, p.Pro290Leufs*70, and p.Pro157Profs*91, and one missense mutation, p.Tyr59Cys. The mutations were scattered within the gene, and no mutational hotspots were found. Genotype-phenotype correlation analysis showed that frameshift or nonsense mutations were correlated with type I BPES, while in-frame or missense mutations were associated with type II BPES. CONCLUSION We report the largest BPES cohort in China thus far as well as seven novel mutations in FOXL2. The identification of novel mutations has not only expanded the mutational spectrum of the gene (which is valuable for mutation detection-based screening) but also suggests that most mutations within the Chinese population may not have been characterized yet.
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Affiliation(s)
- B Lin
- Oculoplasty Department, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yatsen University, Guangzhou, China
| | - B Zeng
- Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China.,Department of Medical Genetics, Zhongshan School of Medicine and Center for Genome Research, Sun Yat-sen University, Guangzhou, China
| | - J Zhao
- Oculoplasty Department, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yatsen University, Guangzhou, China
| | - T Xu
- State Key Laboratory of Respiratory Disease, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Y Wang
- Fetal Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - B Hu
- Fifth Affiliated Hospital, Sun Yat-sen University-BGI Laboratory, Department of Experimental Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - F Li
- Department of Prenatal Diagnostic Center, Guangzhou Women and Children`s Medical Centre, Guangzhou Medical University, Guangzhou, China
| | - Q Zhao
- Department of Obstetrics and Gynecology, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, Guangdong 529030, China
| | - R Liu
- Fifth Affiliated Hospital, Sun Yat-sen University-BGI Laboratory, Department of Experimental Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - J Liu
- State Key Laboratory of Respiratory Disease, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - J M Chen
- Institut National de la Sante et de la Recherche Medicale (INSERM), Brest, France.,Etablissement Francais du Sang (EFS) - Bretagne, Brest, France.,Faculte de Medecine et des Sciences de la Sante, Universite de Bretagne Occidentale (UBO), Brest, France
| | - D Huang
- Oculoplasty Department, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yatsen University, Guangzhou, China
| | - Y Wang
- Xinhua College, Sun Yat-sen University, Guangzhou, China.,Fifth Affiliated Hospital, Sun Yat-sen University, Zuhai 519000, China
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Goel R, A G A, Jain S, K P S M, Nagpal S, Kishore D. Rail-roading technique using 18 gauge intravenous catheter and silicon rod for frontalis suspension in blepharophimosis syndrome. Open Ophthalmol J 2015; 9:8-11. [PMID: 25674190 PMCID: PMC4321230 DOI: 10.2174/1874364101509010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 12/10/2014] [Accepted: 12/11/2014] [Indexed: 11/22/2022] Open
Abstract
Silicon rods are widely employed for frontalis sling suspension. However, on passing through the tissues, at times, the silicon rod gets detached from the stainless steel needle. This occurs more commonly in patients of blepharophimosis syndrome, in which hypoplasia of superior orbital rim with deficiency of skin between lid and brow, causes difficulty in passage of the needle when it is manipulated upwards from lid towards the brow. To overcome these problems we describe the use of an 18 G intravenous catheter to railroad the needle with the silicon rod, obviating the blind upward maneuvers with the needle and protecting against the damage to the silicon rod –needle assembly. The technique is easily reproducible, safe and can be used in all silicon rod suspensions.
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Affiliation(s)
- Ruchi Goel
- Gurunanak Eye center, Maulana Azad Medical College, New Delhi, India
| | - Apoorva A G
- Gurunanak Eye center, Maulana Azad Medical College, New Delhi, India
| | - Sparshi Jain
- Gurunanak Eye center, Maulana Azad Medical College, New Delhi, India
| | - Malik K P S
- Subharti Medical College, Meerut, Uttar Pradesh, India
| | - Smriti Nagpal
- Gurunanak Eye center, Maulana Azad Medical College, New Delhi, India
| | - Divya Kishore
- Gurunanak Eye center, Maulana Azad Medical College, New Delhi, India
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