Surgical Outcomes of Levator Resection in Moderate and Severe Ptosis With a Good Levator Function: A Retrospective Study

Cureus. 2023 Jul 19;15(7):e42136. doi: 10.7759/cureus.42136. eCollection 2023 Jul.

Abstract

Introduction: An abnormally drooping upper eyelid in comparison with the normal position in primary gaze refers to ptosis. Levator resection should be the procedure of choice in patients with moderate to severe ptosis and a good levator function.

Methods: In this retrospective study, we analysed the surgical outcomes after large and maximal levator resection in patients with moderate and severe ptosis with a good levator function and Bell's phenomenon. All patients had a good levator function; therefore, levator resection was the procedure of choice. We performed levator resection of 20 mm and above and the desired post-operative correction was achieved.

Results: One patient had microcornea, and hence, he was undercorrected and his post-operative marginal reflex distance 1 (MRD 1) was 3 mm. Two patients who had severe ptosis pre-operatively had a post-operative MRD 1 of 3 mm. Rest of the patients had a post-operative MRD 1 of 4 mm.

Conclusion: Levator resection of 20 mm or more should be performed in patients with congenital simple ptosis with a good levator function and Bell's phenomenon to achieve a favourable post-operative outcome.

Keywords: congenital simple ptosis; good to fair levator function.; levator resection; moderate to severe ptosis; ptosis.