Maximal Levator Muscle Resection for Primary Congenital Blepharoptosis with Poor Levator Function.

PURPOSE

To evaluate the clinical outcomes of maximal levator muscle resection surgery in patients with poor levator function.

METHODS

This prospective study included 29 eyelids of 23 patients who underwent maximal levator resection surgery. Pre- and postoperatively, all patients' routine ophthalmic examination including evaluation of upper eyelid skin crease positions; levator muscle function (LF), rima palpebrarum (RP), and margin-reflex distance (MRD) measurements were recorded. Outcome was considered successful when the difference between the two upper eyelids was ≤1 mm; if the difference between the two eyelid margins was more than 1 mm and less than 2 mm, it was considered to be satisfactory. More than 2 mm difference was considered to be poor.

RESULTS

Mean patient age was 11.3 ± 8.6 years (3 months to 24 years). Mean follow-up time was 22.8 ± 6.9 months (10 to 36 months). Preoperatively mean RP, MRD, and LF measurements were 5.5 ± 1.7 mm, -0.14 ± 1.6 mm, 2.5 ± 1.4 mm (0-4 mm), respectively. Preoperatively, eight (27,6%) patients had skin crease. Abnormal head posture was detected in eight (34.8%) of the patients. Postoperatively, RP, MRD, and LF values increased significantly (p < 0.05). Mean RP, MRD, and LF measurements were 8.3 ± 1.5 mm, 2.6 ± 1.2 mm, 5.1 ± 2.1 mm, respectively. Fourteen subjects (60.9%) had successful results, two subjects (8.7%) had satisfactory results, and seven subjects (30.4%) had poor results. Abnormal head postures of all patients were resolved.

CONCLUSIONS

Maximal levator resection may be a good alternative method to frontalis suspension in congenital blepharoptosis patients with poor levator function.