June 2013
Volume 54, Issue 15
ARVO Annual Meeting Abstract  |   June 2013
Comparison of Fasanella-Servat and Small-Incision Techniques for Involutional Ptosis Repair
Author Affiliations & Notes
  • Mahsa Sohrab
    Ophthalmology, Northwestern University, Chicago, IL
  • Gary Lissner
    Ophthalmology, Northwestern University, Chicago, IL
  • Footnotes
    Commercial Relationships Mahsa Sohrab, None; Gary Lissner, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 6376. doi:
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      Mahsa Sohrab, Gary Lissner; Comparison of Fasanella-Servat and Small-Incision Techniques for Involutional Ptosis Repair. Invest. Ophthalmol. Vis. Sci. 2013;54(15):6376.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: To compare small-incision external approach and classic Fasanella-Servat internal approach (including tarsus resection) for correction of upper eyelid involutional ptosis.

Methods: Retrospective review of medical records of 93 patients (104 surgical procedures) evaluated at the Northwestern University Department of Ophthalmology between December 2008 to 2011, all of whom underwent small-incision or classic Fasanella-Servat technique ptosis repairs by the same surgeon (GSL). Main outcome measures included patient satisfaction, marginal reflex distance one (MRD1), surgical complications, operating time.

Results: Of the 93 patients, 67% (62/93) were female and 33% (31/93) were male, with overall average age of 69 (+/-14). Of the surgical procedures, 48% (50/104) were small-incision external approaches and 52% (54/104) were Fasanella-Servat internal approaches. Average length of post-operative follow-up was 34.0 days overall (+/-16.0), 32.4 days (+/-17.2) for the Fasanella-Servat group and 38.4 days (+/-15.3) for the small-incision group. MRD1 increased an average of 3.38 mm (+/-0.79) in the Fasanella-Servat group and 2.79 mm (+/-0.8) in the small incision group, and the difference was statistically significant (p<0.001). Pre-operative MRD1 was lower in the Fasanella-Servat group (-0.81 +/- 0.75 versus -0.30 +/-0.43, p<0.001), but post-operative MRD1 was similar between the two groups (2.57 +/-0.54 versus 2.49 +/- 0.56, p=0.5). Average operating time was 53 minutes (+/- 16) in the small incision group and 27 minutes (+/- 6 minutes) in the Fasanella-Servat group (p<0.001). In the Fasanella-Servat group, 61% of patients (33/54) experienced pain on post-operative day one versus 32% of patients (16/50) in the small-incision group (p=0.01). There were no surgical complications in either group with equivalent patient satisfaction between the two groups.

Conclusions: Both the classic Fasanella-Servat internal approach and the small incision external approach lead to good surgical outcomes with equivalent patient satisfaction for cases of involutional ptosis, although the classic Fasanella-Servat approach provides a shorter average operating time with equivalent post-operative MRD1.

Keywords: 526 eyelid • 712 shape and contour • 413 aging  

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