Management of Severe Congenital Ptosis With Supramaximal Levator Muscle Resection

Abstract

Abstract: : Purpose: Sling frontalis technique has become the gold standard surgical method for treating congenital ptosis with poor levator function. We tried to demonstrate that supramaximal levator muscle resection is a good alternative surgical technique for patients with severe congenital ptosis. Methods: Retrospective nonrandomized interventional series with a total of 37 patients with severe congenital ptosis (levator function less than 5mm) who were treated from 1998 to 2003 in Hospital Nacional de Ninos. Results:24 boys (66%) and 13 girls (33%)were treated. The procedure consists of resecting the levator aponeurosis up to Whitnal ligament and suture it to the tarsus. All patients improved with surgery; 19 patients (51%) achieved symmetric results, 2 patients had a difference of 1mm between the two eyes and 16 patients had a final result of 2mm of asymmetry. Only one patient asked for retreatment and the final result was 1mm of asymmetry Conclusions: Supramaximal levator aponeurosis resection is a good technique that has proven to have good results in severe congenital ptosis. The advantages ot this technique are its simplicity and repeatability.

Keywords: eyelid