How to determine the amount of levator resection in congenital ptosis repair

  • Muhamed Ibrahim Hamadamin Rizgary Teaching Hospital, Erbil, Iraq.
  • Jalal Hamasalih Fattah Department of Surgery, College of Medicine, Hawler Medical University, Erbil, Iraq.
Keywords: Congenital blepharoptosis, Levator aponeurosis, Levator resection

Abstract

Background and objective: Levator aponeurosis resection is an effective technique to correct blepharoptosis when the levator function is fair to good. This study aimed to determine the amount of levator resection in congenital blepharoptosis repair.

Methods: This is a prospective case series study conducted in Rizgary teaching hospital and private hospitals in Erbil city, Kurdistan Region, Iraq, from June 2011 to August 2019. The data of 53 patients (64 eyelids) affected by congenital blepharoptosis with poor to good levator function that underwent unilateral orbilateral levator resection blepharoptosis repair through the standard approach were included. The final outcome measures included postoperative eyelid height, contour, and symmetry.

Results: This study includes a total of 53 patients with congenital blepharoptosis (64 eyelids); 20 males and 33 females. The age of the patients ranged from 3 years to 54 years, with a mean age ± SD of 14.11 ± 10.66 years. The ptosis was right sided in 22 patients (41.5%), left sided in 20 patients (37.7%), and bilateral in 11 patients (20.8%). The study showed good patient satisfaction in 66.03% of the cases, suboptimal satisfaction in 22.64% of the cases, and poor satisfaction in 11.32% of the cases.

Conclusion: The levator resection for congenital ptosis is effective even with poor levator function and replaced in our practice the traditional fascial sling. We recommend that further studies be done on a larger number of patients to investigate the effectiveness of levator resection in patients with severe ptosis and very poor levator function.

References

Lee JH, Nam SM, Kim YB. Blepharoptosis correction: levator aponeurosis–Müller muscle complex advancement with three partial incisions. Plast Reconstr Surg 2015; 135(2):388−95.

Hwang K. Surgical anatomy of the upper eyelid relating to upper blepharoplasty or blepharoptosis surgery. Anat Cell Biol 2013; 46(2):93−100.

Baldwin HC, Manners RM. Congenital blepharoptosis: a literature review of the histology of levator palpebraesuperioris muscle. Ophthal Plast Reconstr Surg 2002; 18(4):301−7.

Lin LK, Uzcategui N, Chang EL. Effect of surgical correction of congenital ptosis on amblyopia. Ophthal Plast Reconstr Surg 2008; 24(6):434−6.

Finsterer J. Ptosis: causes, presentation, and management. Aesthetic Plast Surg 2003; 27(3):193−204.

Skaat A, Fabian ID, Spierer A, Rosen N, Rosner M, Simon GJ. Congenital ptosis repair—surgical, cosmetic, and functional outcome: a report of 162 cases. Can J Ophthalmol 2013; 48(2):93−8.

Allard FD, Durairaj VD. Current techniques in surgical correction of congenital ptosis. Middle East Afr J Ophthalmol 2010; 17(2):129.

Keyhani K, Ashenhurst ME. Modified technique and ptosis clamp for surgical correction of congenital pediatric ptosis by anterior levator resection. Facial Plast Surg 2007; 23(03):156−61.

Harvey DJ, Iamphongsai S, Gosain AK. Unilateral congenital blepharoptosis repair by anterior levator advancement and resection: an educational review. Plast Reconstr Surg 2010; 126(4):1325−31.

SooHoo JR, Davies BW, Allard FD, Durairaj VD. Congenital ptosis. Surv Ophthalmol 2014; 59(5):483−92.

Hübner H. Kongenitale Ptosis. Klin Monatsbl Augenheilkd 2012; 229(01):16−20.

Ahmad SM, Della Rocca RC. Blepharoptosis: evaluation, techniques, and complications. Facial Plast Surg 2007; (03):203−15.

Lew H, Goldberg RA. Maximizing symmetry in upper blepharoplasty: the role of microptosis surgery. Plast Reconstr Surg 2016; 137(2):296e−304.

Tuna SH, Gumus HO, Hersek N. Custom-made gold implant for management of lagophthalmos: a case report. Eur J Dent 2008; 2:294.

Abrishami A, Bagheri A, Salour H, Aletaha M, Yazdani S. Outcomes of levator resection at tertiary eye care center in Iran: a 10-year experience. Korean J Ophthalmol 2012; 26(1):1−5.

Published
2021-04-27
How to Cite
Hamadamin, M., & Fattah, J. (2021). How to determine the amount of levator resection in congenital ptosis repair. Zanco Journal of Medical Sciences (Zanco J Med Sci), 25(1), 415-422. https://doi.org/10.15218/zjms.2021.002
Section
Original Articles