J Korean Ophthalmol Soc.  2000 Oct;41(10):2247-2253.

Surgical Results of Levator Resection using the MLD (Margin Limbal Distance)in Congenital Blepharoptosis

• Yang HS
• Ahn JH
• Kim SJ
• Han YS

Abstract

In pediatric patients with congenital blepharoptosis, intraoperative decision of the amount of levator resection is difficult due to general anesthesia.We performed levator resection in 21 eyes of 17 patients with congenital blepharoptosis to evaluate the usefulness of the formula derived from the margin limbal distance (MLD)which was used to determine the amount of levator resection preoperatively. The amount of ptosis (interpalpebral fissure:IPF)was between 3.5 mm and 7.0 mm (mean 4.9 +/-1.2 mm), and less than 6.0 mm in 14 cases (66.4%).The levator function by Berke method was between 3.0 mm and 8.0 mm (mean 5.3 +/-1.7 mm), and between 5.0 mm and 8.0 mm in 13 cases (61.9%).The margin limbal distance was between 0 and 5.0 mm (mean 1.5 +/-1.4 mm), and less than 3.0 mm in 16 cases (76.2%).The amount of levator resection was between 10.0 mm and 22.0 mm, and between 16.0 mm and 18.0 mm in 10 cases (47.6%)which was most frequent. Of 4 patients (8 eyes)with bilateral blepharoptosis, excellent results (IPF > or= 8.0 mm)were achieved in 5 eyes (62.5%)and the other 3 eyes had fair results with IPF of over 6.0 mm.Three patients (75.0%)with bilateral blepharoptosis had symmetric IPF within 1.0 mm difference.In unilateral blepharoptosis, excellent results were achieved in 10 (76.9%)of 13 patients with IPF difference within 1.0 mm, and the other 3 patients had an IPF difference of 1.5 ~2.5 mm. The MLD formula gives the surgeon a good preoperative prediction of the amount of levator to resect, especially in pediatric patients with congenital blepharoptosis to undergo surgery under general anesthesia.

Keyword

Congenital blepharoptosis; Interpalpebral fissure; Levator resection; Margin limbal distance

MeSH Terms

Anesthesia, General
Blepharoptosis*
Humans