Surgical correction of myogenic ptosis using a modified levator resection technique

Abstract

ObjectiveThis report describes our experience using a modified anterior levator resection approach in myogenic ptosis patients and presents the results from a consecutive series of patients treated with this method. DesignThis was a retrospective case series study. ParticipantsForty-one patients with moderate and severe myogenic ptosis were included. MethodsAll patients underwent a modified anterior levator resection approach under local anesthesia. The procedure involved exposing Whitnall’s ligament, dissecting and resecting the underlying levator muscle from Whitnall’s ligament, and leaving the aponeurosis intact. All patients underwent pre- and postoperative photography, and final outcomes were assessed after a minimum of 6 months. Outcome measures included pre- and post-marginal reflex distance (MRD1), symmetry of height, contour, and complications. ResultsForty-one patients undergoing 56 procedures were included. The mean age of the patients was 15 (13–18) years. The mean postoperative MRD1 was 3.45 mm. Thirty-four patients achieved their desired lid height and contour, and 7 patients had undercorrection, including 1 patient with 2 mm of asymmetry, with a final success rate of 83% (34/41 patients). ConclusionsOur modified anterior levator resection approach had a high success rate and is particularly suitable for patients with moderate and severe myogenic ptosis.