Results of Resection of the Levator Muscle Through A Skin Incision in Congenital Ptosis

Abstract

MOST OPHTHALMOLOGISTS believe that resection of the levator gives the best cosmetic and functional results in blepharoptosis.Since some surgeons prefer the external and others the internal approach, a num- ber of operations were done through the skin and the results compared with a previously published report (8) on resection of the levator done through the conjunctiva.This should be a fair and valid estimate of the relative merits of the two procedures because the patients were consecutive in each series, and because the surgery was done at the same institution by essentiallv the same resident and attending surgeons.Since Eversbusch's (1) original description in 1883 for tucking the levator, Meller (2), De Lapersonne (3), Johnson (4), Leahey (5), and others (6-11) have described similar procedures for shortening the levator through the external route. MATERIALThe material for this study comprised 147 operations for resection of the levator through a skin incision on 129 patients with congenital ptosis, 10 of whom had blepharophimosis, 15 hypertropia, and one the jaw-winking phenomenon of Marcus-Gunn.Of the total number, 111 were unilateral and 36 were bilateral operations; 108 were primary procedures and 39 secondary.At the time of operation the youngest patient was 14 months, the oldest 3_ years, and the average age 6X years.The shortest follow-up vas 3 months (3 cases), the longest 531 years and the average 13' years.To simplify the analysis, patients having postnatally acquired ptosis were excluded.