Abstract:

Objective  To investigate the feasibility and efficacy of modified shortening of levator palpebrae superioris muscle for treatment of severe congenital adulthood blepharoptosis. Design Retrospective case series. Participants Twenty-seven cases (36 eyes) of severe congenital ptosis in adults. Methods Charts of consecutive 27 patients, 18 to 45-year old, with severe congenital ptosis, presented from January 2013 to December 2014 were retrospectively reviewed. The patients underwent a modified shortening of levator palpebrae superioris surgery to correct ptosis, and were followed at postoperative 1 year. Clinical efficacy was observed. The evaluation standards were as following. (1) Satisfaction：the upper eyelid margin was 1~2 mm below the upper edge of the cornea and palpebral margin curves naturally without complications; (2) Over-straightening: the position of upper eyelid margin was above the cornea margin; (3) Undercorrection: the upper eyelid margin covered up to 1/3 of the pupil; (4) Recurrence: the upper eyelid margin occluded more than 1/3 pupil. Main Outcome Measures The eyelid position, eyelid curvature and complications (entropion, conjunctival prolapse, exposure keratitis) recorded at the 1 year follow-up visit. Results Twenty-two cases (31 eyes) showed satisfactory correction. One eye showed entropion. Two showed conjunctival prolapse and 2 eyes showed undercorrection. Conclusions Our modified levator muscle resection is effective and safe for treatment of severe adult congenital ptosis in one year. (Ophthalmol CHN, 2018, 27: 362-365)

Key words:  shortening of levator palpebrae superioris muscle, adult, blepharoptosis/congenital