Related Experiment Video
Updated: Mar 3, 2026
Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
Numerical Correlation of Levator Advancement in Preoperative Planning
Valeria Makeeva1, Sherry S Collawn, Evelina N Pierce
1From the *University of Alabama at Birmingham School of Medicine; †Division of Plastic Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL; ‡Department of Pediatrics, University of California, San Diego, La Jolla, CA; and §Morsani School of Medicine, University of South Florida, Tampa, FL.
Background:
Several procedures have been proposed for the treatment of eyelid ptosis, and both levator advancement and levator plication are widely used to shorten the levator palpebrae superioris. The purpose of this study was to quantify perioperative lid measurements in patients undergoing bilateral levator aponeurosis advancements to aid in preoperative planning.
Methods:
Between July 2014 and June 2016, the authors performed a retrospective analysis of all bilateral upper eyelid levator advancement procedures for ptosis performed by the senior surgeon. There are a total of 21 patients (6 men and 15 women) with a mean age of 63 years (range, 48-79 years). The average time at follow-up was 5.3 months, with a range of 1 to 26 months.
Results:
In this retrospective study, we collected data on presurgical measurements including marginal reflex distance 1 (MRD1), surgical technique used (symmetrical/asymmetrical levator advancement) with millimeters of advancement used, and postsurgical measurements. We found that on average, an advancement of 4 mm led to an improvement in MRD1 of 2.26 mm (n = 14), and advancement of 5 mm led to an improvement in MRD1 of 2.74 mm (n = 15). Patients also reported improvements in their quality of life.
Conclusions:
Our results may be used to guide clinicians in preoperative planning.
