Modified tarsal resection operation for congenital ptosis with fair levator function.

Area of Science:

• Ophthalmology
• Surgical Techniques
• Congenital Disorders

Background:

• Congenital ptosis management involves various surgical options for cases with fair levator function.
• The modified tarsal resection method, combining tarsus, Müller muscle, and conjunctiva resection with levator aponeurosis advancement, is presented as a viable surgical approach.

Purpose of the Study:

• To review a 10-year surgical experience with an en bloc resection of tarsus, Müller muscle, and conjunctiva combined with graded levator aponeurosis advancement for congenital ptosis.
• To evaluate the efficacy and outcomes of this specific surgical technique in patients with fair levator function.

Main Methods:

• A retrospective case series analyzing 30 patients with congenital ptosis and fair levator function who underwent the modified tarsal resection method between 1994 and 2004.
• Data collected included pre- and postoperative eyelid margin to reflex distance, levator function, extent of tissue resection, and complications.

Main Results:

• The average preoperative upper eyelid margin to reflex distance was 0.0 mm, improving to 2.8 mm postoperatively.
• Eighty-three percent (25 of 30) of patients achieved a "good" surgical outcome.
• The extent of tarsus-Müller muscle resection correlated with the degree of eyelid elevation; transient lagophthalmos was the primary complication.

Conclusions:

• The en bloc resection of tarsus, Müller muscle, and conjunctiva with levator aponeurosis advancement is a reliable technique for congenital ptosis with fair levator function.
• This method yielded superior results compared to isolated maximal levator aponeurosis advancement in the authors' experience.