Blepharoptosis correction by excision of levator muscle and tarsus in Asians

To establish a technique for moderate and severe blepharoptosis to exert the function of residual levator muscle, 30 patients (38 eyes) who had moderate and severe blepharoptosis were treated, and the results including complications were followed up and valued. Operation was performed via anterior transcutaneous incision. After separating levator muscle and tarsus, the amount excision of levator muscle and tarsus was accurately estimated. Part of levator muscle associated with tarsus was excised. The position and contour of the upper lid margin, uncovering of the pupils, and symmetry of the palpebral fissures were assessed. Incidence of postoperative complications, including infection, was also considered. Among the 38 eyes, all had a good or fair outcome except for 2 eyes. Eyelid was raised to normal level by this technique with a natural eyelid contour. Some cases presented slight neuropathies in the early stage after operation. We concluded that excision of levator muscle and tarsus could be applied to correct moderate and severe blepharoptosis with some residual levator function, which could achieve good aesthetic results ultimately.