Small-Incision Levator Resection for Correction of Congenital Ptosis: A Prospective Study Publisher Pubmed



Eshraghi B¹ ; Ghadimi H¹ Show Affiliations
Source: Graefe's Archive for Clinical and Experimental Ophthalmology Published:2018

Abstract

Purpose: To determine the rate of success of small-incision levator resection technique for correction of congenital ptosis. Methods: Patients with congenital ptosis who were candidates for levator resection were enrolled if their levator function was not poor (< 5 mm). Incisions were made on upper eyelid crease with a length of 10–12 mm. After resection of adequate length of levator muscle, two sutures were used to fix it to tarsal plate. Sliding the incision to medial and lateral sides provided a wider field of access to allow the surgeon to place the sutures above nasal and temporal borders of limbus. Success was defined as margin reflex distance-1 (MRD-1) ≥ 3 mm and inter-eyelid difference of MRD-1 less than 1 mm, which was considered excellent if inter-eyelid difference was < 0.5 mm and good if the latter parameter was between 0.5 and 1 mm. Results: Fifty eyes of 47 congenital ptosis cases (16 males and 31 females) were included. Average age was 21.7 ± 9.7 years (range, 3–44 years). Mean preoperative levator function and MRD-1 were 11.26 ± 2.79 and 1.78 ± 0.92 mm, respectively, while postoperative MRD-1 increased to 3.95 ± 0.82 mm (P < 0.001). The result was failure (undercorrection) in 12 cases (25.5%), good in 9 patients (19.2%), and excellent in 26 cases (55.3%). Conclusions: Small-incision levator resection has previously been studied for correction of aponeurotic ptosis and proved to yield successful outcome. The findings of this study suggest that small-incision technique can be effectively used in correction of congenital ptosis, as well. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.