A Total Lid Resection Selectively with Levator Aponeurosis Resection for the Treatment of Blepharoptosis

Ahn, Ki Young

Abstract

Blepharoptosis refers to drooping of upper eyelid due to weakness of the levator muscle or Mllers muscle. This results in not only a loss of visual field but also aesthetic problems. There has been many procedures in correction of ptosis; A vertical lid-shortening operation such as the Fasanella-Servant tarsomullectomy, advancement of the levator aponeurosis, a external or conjunctival levator muscle resection, and Frontalis suspension or transfer. These methods have many advantage and disadvantages respectively and it is very difficult to have a choice for any ptosis. We modified levator aponeurosis resection to reduce undercorrection and recurrence of the ptosis after operations. The refinement of our procedure consist of the skin approached semilunar resection of total upper eyelid with levator aponeurosis resection according to ptosis amount. From January 1997 to June 2002, 10 congenital and acquired blepharoptosis patients and 10 cases were done. The follow-up period of patients ranged from 9 months to 6 years and 2 months. The preoperative average amount of ptosis is 3.3 mm and the postoperative one is 1.6 mm. Satisfactory result has been achived in 8 cases. Undercorrection and temporary severe lagophthalomos were done 2 cases and 3 cases respectively, but we did not have any expirences of severe complication such as exposure keratitis and symblepharon. Although our method has some disadvantages such as somewhat difficult procedure and longer operation times, better results and less recurrence of ptosis were done after long term follow-up.