Small incision versus conventional transcutaneous levator resection in the management of ptosis with good and excellent levator action

Abstract

Purpose The aim of this study is to compare small incision levator and conventional transcutaneous levator resection in the management of cases of ptosis with good and excellent levator action. Patients and methods This is a prospective comparative study that included 30 patients with unilateral ptosis, 16 cases with congenital, and 14 cases with aponeurotic ptosis. Levator action was good (>10 mm levator excurtion) in 20 cases and excellent (>15 mm levator excurtion) in 10 cases. Fifteen cases (group B) were operated through a small (8 mm) upper lid crease incision through which sutures were passed from the tarsal border to the levator muscle at the target distance and 15 cases (group A) were operated through a conventional transcutaneous levator resection. Results This study included 30 cases of unilateral ptosis. They were divided into two groups: group A was operated by a conventional technique and group B was operated by a small incision technique. In group A, 80% of cases were fully corrected, 13.3% were undercorrected, and 6.7% were over corrected; however, in group B, 86.7% were fully corrected and 13.3% were undercorrected. The mean surgical time in group A was 49.5 ± 5.9 and that in group B was 28.1 ± 5.2. Conclusion This study shows that small incision levator muscle resection is equally effective as the conventional transcutaneous levator resection for the management of ptosis, with good and excellent levator action, with better lid contour and quicker time.