Correction of postoperative eyelid retraction with a simplified levator palpebrae superioris (LPS) muscle recession: analysis of a 10-year experience.

A simplified levator palpebrae superioris (LPS) muscle recession was performed to correct eyelid retraction in 56 eyelids of 48 patients. Improvement of preoperative keratopathy and cosmetically acceptable results were achieved in 93% of the eyelids. Based on preoperative surgical intervention, eyelids were divided into four groups: levator resection, levator aponeurosis advancement, surgery associated with dysthyroid ophthalmopathy, and miscellaneous reconstructive eyelid procedures. For each group the mean preoperative and postoperative eyelid levels, the mean change in eyelid level following surgery, and the mean amount of surgery performed were analyzed statistically with the two-tailed student's t-test. Linear regression was used to analyze the relationship between the change in eyelid level and the amount of levator recession performed. No significant relationship was demonstrated between eyelid retraction and dysthyroid ophthalmopathy or reconstructive eyelid surgery. However, a significant relationship was demonstrated between the amount of recession and the eyelid level change for eyelids retracted following levator resection (P less than .01) and levator aponeurosis surgery (P less than .05). This may indicate that the change in eyelid level following a simplified LPS recession in these two groups is predictable. However, additional prospective studies are required to further assess the clinical applicability and use of this finding.