Lung-Chen Tu
Director
Department of Aesthetic Medicine,
Cheng Hsin General Hospital
Taiwan
Topic: Transconjunctival Union-Triad Tissue Technique (TUTTT) for Severe
Blepharoptosis Correction
Abstract:
According to Rycroft “ancient Arabian ophthalmologists” provide the first reference of eyelid surgery for
the treatment of ptosis. About 100 ad, the encyclopedist of Greek and Roman surgery, Aulus Cornelius
Celsus first documented the resection of eyelid skin for the treatment of ptosis in De Re Medica. After
1806, ptosis surgery undergoes many revolutions as knowledge of anatomy and physiology progresses
and as types of materials expand.
Interest in the frontalis suspension technique is renewed with Dransart in 1880 as he uses buried catgut
sutures to suspend the lid to the brow. The frontalis suspension technique had been used to treat severe
blepharoptosis since than and performed for many surgeons till now for the difficulties in dealing with
severe blepharoptosis. However, there were some drawbacks on this procedure for under correction ,
lagophthalmos and unnatured occurred.
Base on ower studies of initiate surface electromyography (SEMG) data analysis of upper eyelid ptosis
correction by transconjunctival incisions to assess the performance of eyelid muscle controlling, we
proposed a method by using transconjunctival triad tissue of Muller” s muscle, levator aponeurosis and
conjoint fascia sheath to treat the severe blepharoptosis. 88 patients ( 130 eyes ) receiving
transconjunctival union- triad tissue technique ( TUTTT) correction for the severe blepharoptosis were
included in this study. Mean preoperative margin reflex distance was 0.74mm (−2.5 to 2mm) and the
mean postoperative margin reflex distance was 3.39mm (1 to 5.0mm). There was no lagophthalmos
occurred in all patients. The transconjunctival union-triad tissue technique (TUTTT) is effective in dealing
with severe blepharoptosis.
