Comparison between surgical outcome between levator resection and levator aponeurosis tucking with non absorbable sutures in mild and moderate unilateral congenital ptosis

Abstract

Abstract Purpose To compare levator tucking with resection in mild and moderate congenital ptosis: Methods Prospective comparative randomized trial involving 20 eyes of 20 patients, simple mild-to-moderate congenital ptosis with good-to-fair amount of levator action were included. Patients were randomized to either levator resection or tucking. Outcome was compared in terms of eyelid height and course of postoperative events. Data collected included margin reflex distance (MRD1), symmetry of eyelid height, contour and complications. Surgery was considered successful if the following three criteria were simultaneously met: A postoperative MRD1 of ≥ 2 mm and ≤4.5 mm, inter-eyelid height asymmetry of ≤ 2 mm, and satisfactory eyelid contour. Results Mean age was 12.9 years in resection group (range 5–25 years) and 12.20 years in tucking group (range 4-23 years) postoperative follow-up was 3 months comparing post operative levator function between resection and tucking group was statistically significant (P-value 0.025) tucking didnot improve levator function as much as levator resection did. Mean preoperative palpebral fissure height was 7.8 ml in resection group and6.9 ml in tucking group and the mean postoperative palpebral fissure height was 10.0 mm in resection group and 8.9 mm in tucking group. Conclusion Both levator resection and levator tucking are safe and efficient in correcting minimal and moderate degree of congenital blepharoptosis, with less recurrence in levator muscle resection