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1 Aesthet Surg J. 2010 May-Jun;30(3):320-8. doi: 10.1177/1090820X10374108.
. Evaluation and management of unilateral ptosis and avoiding contralateral
Zoumalan CI1, Lisman RD.
Author information:
1Division of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, New Yor
Abstract
Treating unilateral ptosis can be challenging and a proper preoperative evaluation may help prevent
should include testing for Hering's law, which remains useful in understanding the phenomenon of in
10% to 20% of patients with unilateral ptosis have some degree of induced retraction on clinical eval
preoperative examination, the surgeon should consider a bilateral ptosis procedure. The surgical ap
etiology, and the surgeon should be aware of which procedure is most likely to provide the best outc
PMID: 20601555 [PubMed - indexed for MEDLINE]
1 Aesthet Surg J. 2015 Sep;35(7):774-81. doi: 10.1093/asj/sjv052. Epub 2015 Apr 24.
. The Effect of Hering's Law on Different Ptosis Repair Methods.
Nemet AY1.
Author information:
1Dr Nemet is the Director of Oculoplastic Service in the Department of Ophthalmology at the Meir Me
School Tel Aviv University, Tel Aviv, Israel, and Chair of the Israeli Society of Ophthalmic Plastic and
Comment in
• Commentary on: The Effect of Hering's Law on Different Ptosis Repair Methods. [Aesthet Surg J.
Abstract
BACKGROUND:
The Hering's law effect has significant importance in surgical planning and outcomes of eyelid surge
OBJECTIVES:
The current study examined the preoperative and intraoperative effect of Hering's law in Mullerectom
METHODS:
A retrospective analysis was conducted of 52 patients with unilateral ptosis who underwent surgical
aponeurosis advancement or Mullerectomy with or without tarsectomy. Preoperative and postoperat
Hering's dependency and postoperative changes in positioning of the non-operated eyelid were mea
was based on preoperative Hering's dependence and intraoperative changes in the contralateral eye
RESULTS:
Fifty-two patients with unilateral ptosis were included. Average age was 63.3 ± 20.1 years (range, 22
were not aponeurotic (either congenital, secondary to trauma, or due to postoperative ptosis) did not
in 9 (52.9%) cases of levator advancement, both eyelids required surgery (p = .029). Hering's law ef
than in Mullerectomy.
CONCLUSIONS:
Levator surgery resulted in a higher incidence of combined intraoperative and postoperative Hering's
congenital ptosis can be repaired unilaterally with no need for contralateral surgery. The fibrotic leva
phenomenon. This should be considered in surgical planning.
© 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.p
PMID: 25911628 [PubMed - indexed for MEDLINE]
. Plast Reconstr Surg. 2001 Nov;108(6):1527-36; discussion 1537-8.
Upper eyelid ptosis repair after cataract extraction and the importance of H
Parsa FD1, Wolff DR, Parsa NN, Elahi aE E.
Author information:
1Division of Plastic Surgery, John A. Burns School of Medicine, University of Hawaii, Honolulu, USA.
Comment in
• Upper eyelid ptosis repair after cataract extraction and the importance of Hering's test. [Plast Reco
Abstract
Blepharoptosis is a well-documented complication of cataract extraction and other ocular procedures
postcataract blepharoptosis repair. The authors present a review of the causes of postcataract bleph
treatment on the basis of their experience with 13 eyelids in eight patients over the past 10 years. Th
levator muscle from the tarsal plate. Of the eight patients in this series, five had bilateral blepharopto
postcataract blepharoptosis is commonly assumed, the authors propose that the mechanical forces
are the primary cause. This is further supported by their operative findings in the five patients who de
series were repaired by levator muscle advancement and attachment to the tarsal plate with favorab
of Hering's phenomenon of equal innervation is also discussed as it applies to bilateral and to appar
important indicative study in the preoperative evaluation of all patients with eyelid ptosis.
PMID: 11711923 [PubMed - indexed for MEDLINE