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Whitnall's sling for poor function ptosis.

R L Anderson1, D R Jordan, J J Dutton

  • 1Department of Ophthalmology, University of Utah School of Medicine, Salt Lake City.

Archives of Ophthalmology (Chicago, Ill. : 1960)
|November 1, 1990
PubMed
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Whitnall's sling surgery offers a superior alternative for severe unilateral ptosis with poor levator function. This technique preserves key anatomical structures, yielding satisfactory long-term results comparable to traditional methods.

Area of Science:

  • Ophthalmology
  • Surgical Techniques
  • Ptosis Correction

Background:

  • Severe unilateral ptosis with poor levator function traditionally managed with maximal levator resection or frontalis suspension.
  • Existing methods may involve significant structural alteration.

Purpose of the Study:

  • To introduce and evaluate the efficacy of the "Whitnall's sling" technique for correcting severe unilateral ptosis.
  • To compare the outcomes of Whitnall's sling with traditional maximal levator resection.

Main Methods:

  • Resection of only the levator aponeurosis, preserving Whitnall's ligament and its attachments.
  • Suturing Whitnall's ligament and resected levator muscle to the superior tarsal plate.
  • Inclusion of a 5-mm superior tarsectomy in recent cases for additional elevation.

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Main Results:

  • Satisfactory outcomes in 69 eyelids with a minimum 1-year follow-up.
  • Results directly correlated with preoperative levator function.
  • Preservation of levator muscle, Müller's muscle, and Whitnall's ligament, maintaining tear film structures.

Conclusions:

  • Whitnall's sling is anatomically and physiologically superior to maximal levator resection for ptosis correction.
  • The technique provides comparable long-term results while preserving ocular structures.
  • Optimal patient selection includes cases with contralateral fissure height ≤9 mm and ptotic eyelid levator function of 3-5 mm.