Tarsal resection operation in correction of severe unilateral blepharoptosis with poor levator function

Abstract

There are many options for surgical repair of congenital unilateral ptosis with poor levator function. We performed resection of tarsus, Muller muscle, and conjunctiva in conjunction with an intraoperative adjustable levator resection. Resection of tarsus, Muller muscle, and conjunctiva in conjunction with levator resection was performed in a prospective series of 17 consecutive patients with unilateral ptosis with poor levator function over a 2-year period. Pre- and postoperative upper eyelid margin to reflex distance, degree of levator function, amount of operative tarsus and Muller muscle resection, postoperative eyelid symmetry, and postoperative complications were evaluated. Mean preoperative upper eyelid margin to reflex distance was 0.11 mm. Mean postoperative upper eyelid margin to reflex distance was 3.20 mm. Improved postoperative eyelid symmetry within 1.0 and 1.5 mm was demonstrated in most of our cases (58% and 76%, respectively). The major complication has been exposure keratitis. Resection of tarsus, Muller muscle, and conjunctiva combined with adjustable levator resection can correct severe unilateral ptosis with poor levator function.