The modified fasanella-servat procedure: description and quantified analysis.

Area of Science:

• Ophthalmology
• Oculoplastic Surgery

Background:

• Blepharoptosis, or drooping eyelids, can affect vision and aesthetics.
• Existing surgical techniques for ptosis correction vary in complexity and outcomes.
• Minimal ptosis (< 2.5 mm) with good levator function requires precise and minimally invasive treatment.

Purpose of the Study:

• To describe a modified Fasanella-Servat procedure for correcting minimal blepharoptosis.
• To introduce a nomogram to guide tarsectomy amount based on ptosis severity.
• To evaluate the efficacy and safety of this modified technique.

Main Methods:

• Retrospective review of 118 eyelids in 86 patients undergoing the modified Fasanella-Servat procedure.
• Tarsectomy amount was determined by the degree of ptosis.
• Surgical outcomes were assessed by margin-to-reflex distance (MRD1) and eyelid symmetry.

Main Results:

• Mean MRD1 improved from +0.7 mm to +2.4 mm post-surgery.
• 95% of eyelids achieved satisfactory MRD1 (≥ 1.5 mm).
• 92% achieved excellent eyelid symmetry (within 0.5 mm); low complication rate reported.

Conclusions:

• The modified Fasanella-Servat procedure is technically straightforward, efficient, and safe for minimal blepharoptosis.
• It demonstrates a low complication rate, making it a valuable addition to ptosis surgery options.
• The technique, with a tarsectomy to eyelid elevation ratio of approximately 2:1, is a useful adjunct for ptosis surgeons.