Levator Function in Blepharoptosis Surgery
20 February 2013 (online)
Aim To investigate the predictive value of levator function in the outcomes of surgeries using the anterior levator resection technique in patients with aponeurotic blepharoptosis.
Methods A retrospective analysis of 69 eyes of 65 patients who underwent anterior levator resection between 2005 and 2011 in the ophthalmology department of a tertiary care center was performed. Levator function was assessed as perfect (10 to 15 mm; group 1), good (9 to 10 mm; group 2), and moderate (5 to 8 mm; group 3). Postoperative success rates were analyzed with respect to preoperative levator function.
Results The patient group consisted of 36 females (55.4%) and 29 males (44.6%) with a mean age of 57.2 (range: 16 to 71) years and average duration of follow-up of 13.7 (range: 6 to 36) months. The rates of success in the first, second, and third groups were 84.6%, 84%, and 71%, respectively. The success rate was found to be significantly lower in the third group (p < 0.05). The overall success rate, which was 78.3%, improved to 87% after revision surgery.
Conclusion In patients with aponeurotic blepharoptosis with relatively better preoperative levator function, the anterior levator resection technique seems to yield more successful surgical outcomes. Preoperative assessment of levator function may help in the selection of appropriate treatment modality in these patients.
- 1 DiFrancesco LM, Codner MA, McCord CD. Upper eyelid reconstruction. Plast Reconstr Surg 2004; 114: 98e-107e
- 2 Dortzbach RK, Sutula FC. Involutional blepharoptosis. A histopathological study. Arch Ophthalmol 1980; 98: 2045-2049
- 3 Lemagne JM. Idiopathic aponeurotic ptozis in young adults. Orbit 1994; 13: 179-182
- 4 Maegawa J, Kobayashi S, Yabuki Y, Hirotomi K, Yasumura K, Iwai T. Blepharoplasty in senile blepharoptosis: preoperative measurements and design for skin excision. Aesthet Surg J 2012; 32: 441-446
- 5 Anderson RL, Beard C. The levator aponeurosis. Attachments and their clinical significance. Arch Ophthalmol 1977; 95: 1437-1441
- 6 Beard C. The surgical treatment of blepharoptosis: a quantitative approach. Trans Am Ophthalmol Soc 1966; 64: 401-487
- 7 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: 1-5
- 8 Chang S, Lehrman C, Itani K, Rohrich RJ. A systematic review of comparison of upper eyelid involutional ptosis repair techniques: efficacy and complication rates. Plast Reconstr Surg 2012; 129: 149-157
- 9 Jordan DR, Anderson RL. The aponeurotic approach to congenital ptosis. Ophthalmic Surg 1990; 21: 237-244
- 10 Kim JH, Lee IJ, Park MC, Lim H, Lee SH. Aesthetic blepharoptosis correction with release of fibrous web bands between the levator aponeurosis and orbital fat. J Craniofac Surg 2012; 23: e52-e55
- 11 Cahill KV, Bradley EA, Meyer DR , et al. Functional indications for upper eyelid ptosis and blepharoplasty surgery: a report by the American Academy of Ophthalmology. Ophthalmology 2011; 118: 2510-2517
- 12 Cates CA, Tyers AG. Outcomes of anterior levator resection in congenital blepharoptosis. Eye (Lond) 2001; 15 (Pt 6) 770-773
- 13 Shore JW, Bergin DJ, Garrett SN. Results of blepharoptosis surgery with early postoperative adjustment. Ophthalmology 1990; 97: 1502-1511
- 14 Lee IJ, Park MC, Lim H, Kim JH, Lee SH. Blepharoptosis correction: repositioning the levator aponeurosis. J Craniofac Surg 2011; 22: 2284-2287