Abstract
Objective To establish a treatment protocol for severe blepharoptosis. This protocol helps to achieve better accuracy and more stable result. Methods Evaluate levator muscle function pre-operatively. When levator function ≤ 1 mm, frontalis suspension technique was performed. When levator function more than 1 mm, technique of levator resection, combining excision of tarsus and levator, and tarsus-levator-CFS suspension was performed accordingly until it reaches adequate correction result during the surgery. Results A total of 275 severe ptosis patients was included from January 2015 to June 2016. 52 cases (388 eyes) received levator resection. 162 cases received combining excision of tarsus and levator. 24 cases received tarsus-levator- CFS suspension. 37 cases received frontalis suspension. 326 eyes achieved adequate correction results. 62 cases were still undercorrected. The asymmetry result showed that 76 cases presented good symmetry. 142 cases presented moderate asymmetry and 57 showed severe asymmetry. Conclusions The new treatment protocol shows a satisfactory result with better accuracy and more stable correction for severe ptosis correction. Key words: Blepharoptosis; Levator palpebrae superioris; Tarsal plate; Frontalis muscular flap suspension
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