Treatment of congenital ptosis by maximal levator resection.

The treatment of severe congenital ptosis may include frontalis suspension or maximal levator resection. A previous study of 145 consecutive frontalis suspensions for congenital ptosis showed a fairly high recurrence rate, frequent granuloma formation, and significant brow scars. In 28 patients undergoing 32 maximal levator resections utilizing our technique, 28 patients had excellent results. Two required reoperations and two additional patients had undercorrections that did not warrant reoperation. There were no significant complications. We believe that maximal levator resection is a better surgical alternative than frontalis suspension in the treatment of severe congenital ptosis whether unilateral or bilateral. In our experience, maximal levator resection provides a better cosmetic result and the recurrence rate is probably less than with frontalis suspension.