Levator Resection in the Management of Myopathic Ptosis
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Purpose: To evaluate the results of levator resection in patients with myopathic ptosis. Methods: The medical records of consecutive patients who underwent levator resection surgery performed formyopathic ptosis between October 2009 and March 2013 were reviewed. Indications for surgery were ptosisobscuring the visual axis and margin-reflex distance ≤2 mm. Surgical success was defined as clear pupillaryaxis when the patient voluntarily opened his eye and margin-reflex distance ≥3 mm. We analyzed the effect oflevator function and Bell’s phenomenon on the rates of success and corneal complication. Results: This series included six male and six female patients. Levator function was between 4 and 12 mm. Weperformed bilateral levator resection surgery in all patients. The mean follow-up time was 14.8 months (range,6 to 36 months). No patient was overcorrected. Adequate lid elevation was achieved after the operation in 20eyes. Ptosis recurred in three out of 20 eyes after adequate lid elevation was achieved. Our overall successrate was 70.8%. In three eyes with poor Bell’s phenomenon, corneal irritation and punctate epitheliopathy thatrequired artificial eye drops and ointments developed in the early postoperative period, although symptomsresolved completely within 2 months of the resection surgery. No patients required levator recession or anyother revision surgery for lagophthalmos or corneal exposure after levator resection. Conclusions: Levator resection seems to be a safe and effective procedure in myopathic patients with moderateor good Bell’s phenomenon and levator function greater than 5 mm.
Abstract
Purpose: To evaluate the results of levator resection in patients with myopathic ptosis. Methods: The medical records of consecutive patients who underwent levator resection surgery performed formyopathic ptosis between October 2009 and March 2013 were reviewed. Indications for surgery were ptosisobscuring the visual axis and margin-reflex distance ≤2 mm. Surgical success was defined as clear pupillaryaxis when the patient voluntarily opened his eye and margin-reflex distance ≥3 mm. We analyzed the effect oflevator function and Bell’s phenomenon on the rates of success and corneal complication. Results: This series included six male and six female patients. Levator function was between 4 and 12 mm. Weperformed bilateral levator resection surgery in all patients. The mean follow-up time was 14.8 months (range,6 to 36 months). No patient was overcorrected. Adequate lid elevation was achieved after the operation in 20eyes. Ptosis recurred in three out of 20 eyes after adequate lid elevation was achieved. Our overall successrate was 70.8%. In three eyes with poor Bell’s phenomenon, corneal irritation and punctate epitheliopathy thatrequired artificial eye drops and ointments developed in the early postoperative period, although symptomsresolved completely within 2 months of the resection surgery. No patients required levator recession or anyother revision surgery for lagophthalmos or corneal exposure after levator resection. Conclusions: Levator resection seems to be a safe and effective procedure in myopathic patients with moderateor good Bell’s phenomenon and levator function greater than 5 mm.
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