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Subject Area

Dermatology

Article Type

Original Study

Abstract

Objective The aim was to evaluate the surgical effect of maximal levator muscle resection technique for moderate to severe simple congenital blepharoptosis with poor levator function. Background Surgical treatments for the correction of congenital ptosis with poor levator function including frontalis suspension or maximal levator resection remain controversial. However, the levator resection approach seems to be the most physiological. Maximal levator resection, assuming that it is employed appropriately, is highly effective in cases of moderate to severe congenital ptosis with poor levator function. This surgery advances and plicates the levator muscle, thus increasing its effect. Patients and methods This prospective study included 29 eyelids of 20 patients who underwent maximal levator resection procedure, and their ages ranged from 3 to 8 years. Patients who presented with ptosis were examined and enrolled from January 2018 to January 2019, from the Outpatient Ophthalmic Clinic of Menoufia University Hospital. Follow-up was done at first week, first month, and sixth month postoperatively to evaluate the functional, cosmetic results, and complications. Results There is a statistically significant increase of mean postoperative marginal reflex distance-1 (MRD-1) at first week, first month, and sixth month in comparison with preoperative MRD-1 (P < 0.05). Successful outcome of the maximal levator resection procedure that was evaluated by postoperative MRD-1 was met by 79.31% (23/29) in the first week, 82.76% (24/29) in the first month, and 86.21% (25/29) in the sixth month. Satisfactory eyelid contour was met by 28 of 29 eyelids. The most common complications at 6 months were undercorrection in 10.3% (3/29) and overcorrection in 3.4% (1/29). Conclusion Maximal levator resection procedure is very effective in the treatment of simple congenital blepharoptosis with poor levator function.

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