Levator lengthening by marginal myotomy.

A surgical procedure has been designed for lengthening the levator aponeurosis by two partial-width (marginal) myotomy incisions. This operation does not require complete division or disinsertion of the levator, Müller's muscle, or tarsus. No foreign materials or sclera need to be inserted into the lid. The procedure has been used to treat upper lid retraction due to ophthalmic Graves' disease and for eyelid reconstruction after resection of basal cell carcinoma that involves the lid margin. Since an anterior incision is made through the skin, adhesions between the levator aponeurosis and the overlying tissues may be divided in patients with Graves' disease.