Outcome of Levator Advancement Procedure for Treatment of Congenital Blepharoptosis


ABSTRACT:BACKGROUND: Eyelid Ptosis is classified according to etiology as congenital or acquired, simple congenital ptosis is the most common form characterized by fatty dystrophy and fibrosis of the levator muscle which leads to a restricted elevation in upgaze and a lid lag in downgaze. The choice of operation depends on the grade of ptosis and the levator function.OBJECTIVE: To evaluate the effectiveness of levator advancement technique for treatment of congenital blepharoptosis.PATIENTS AND METHODS: A prospective study done in Surgical Specialities Hospital-Medical City and Rizgary Teaching Hospital between June 2012 -June 2016; levator advancement technique was applied for treating all patients with congenital blepharoptosis with fair to excellent levator function. In this study 69 patients (77 eyelids) were included, 8 patients (11.6%) had bilateral ptosis and 61 patients (88.4%) had unilateral ptosis, some cases presented primarily for revision of ptosis. Patients ages range is (4.5-52 years), the post-operative follow up period was from 3 months up to 24 months . RESULT: In the 69 patients with congenital ptosis who were treated by levator advancement technique 7 eyelids (9% of total operated eyelids) was found to have levator dehiscence ,we found that success rate was (80.5%) as a final outcome after both the primary and revision surgery , the most common complication was under-correction in 8 cases, surgical revision performed in 8 cases (10.3%) for different reasons. Statistically significant relationship between preoperative and post-operative vertical palpebral fissure height (P < 0.0001) and degree of ptosis (P <0.0001) was observed. CONCLUSION: Levator advancement with/without resection has a high success rate and few complications in the surgical treatment of congenital ptosis with all degree of ptosis with fair to good levator function..