My Experience with Levator Resection Surgery in Congenital Ptosis

Aims: To assess the effectiveness of Levator resection surgery in patients with moderate to severe congenital ptosis with poor Levator function.

Materials and Methods: Settings and Design: A prospective, observational, single institutional study done in 2003-2010 at a referral Government College draining poor patients.

52 eyes of 49 pts with moderate to severe ptosis were selected. All had poor Levator Palpebrae Superioris (LPS) action. Marcus Gunn ptosis and Acquired Ptosis were excluded. These underwent Levator resection surgery through skin approach. LPS was resected according to severity of ptosis.

Postoperative ptosis correction, lid position, contour, lid lag and any other complications were noted. Results of ptosis correction were grouped as:

1. Good if postop. Lid height was within 1 mm of the desired height or with respect to the opposite lid.

2. Satisfactory if 1-2 mm undercorrection was seen.

3. Poor if > 2 mm undercorrection occurred or any other cosmetic blemish like lagophthalmos, notching of lid border or abnormal lid fold.

Follow up was done at 1 wk, 6 wks, 6 mths, then yearly till 5 years.

Results: 43 eyes (82.69%) showed good correction, with good primary eye lid position and no corneal complications.

7 eyes (13.46%) showed satisfactory correction.

2 eyes (3.84%) showed poor correction. 1- overcorrection, 1- undercorrection

Conclusions: Levator resection surgery is an effective procedure of choice even for congenital ptosis with poor LPS action.