A Modified Approach to Transconjunctival Levator Advancement Offering Intraoperative Options.

Abstract

The transconjunctival technique is an effective approach to mild to moderate blepharoptosis repair that does not involve skin incision. However, accurate surgical manipulation of this method is greatly restricted by poor intraoperative evaluation. The aim of this study was to introduce a modified transconjunctival approach with flexible intraoperative adjustments in order to achieve more accurate ptosis correction. Taking a transconjunctival approach, the levator aponeurosis and Müller's muscle were folded with a square-like mattress suture for flexible adjustment and accurate correction. In 18 mild ptosis eyelids, 94.5% (17 eyelids) achieved adequate or normal correction. In 9 eyelids with moderate ptosis, 88.9% (8 eyelids) achieved adequate or normal correction. Of 24 ptosis patients, 23 (95.8%) achieved a good or fair symmetry result. This study presents a modified transconjunctival technique for repair of mild to moderate ptosis, which is characterized by flexible intraoperative adjustments that produce satisfying functional and aesthetic outcomes.