Four-Step Levator Aponeurosis Plication Technique for Mild-Moderate Congenital Blepharoptosis

Area of Science:

• Ophthalmology
• Plastic Surgery

Background:

• The standard levator aponeurosis plication technique is effective for mild blepharoptosis but presents challenges for moderate cases, including inadequate correction and aesthetic concerns.
• Modifications to the levator aponeurosis plication technique are explored to expand its application to moderate blepharoptosis, aiming for improved functional and cosmetic results.

Purpose of the Study:

• To evaluate the efficacy and safety of a modified 4-step levator aponeurosis plication technique for treating mild to moderate congenital blepharoptosis.
• To compare the outcomes of the 4-step technique in patients with mild versus moderate blepharoptosis.

Main Methods:

• A retrospective study included patients with mild-moderate congenital blepharoptosis who underwent the 4-step levator aponeurosis plication.
• Data collected from May 2022 to December 2023.
• Level IV evidence.

Main Results:

• The study included 76 patients (117 eyes) with mild ptosis and 56 patients (88 eyes) with moderate ptosis.
• Postoperative Marginal Reflex Distance 1 (MRD1) significantly improved in both groups compared to preoperative measurements.
• No significant differences were observed between mild and moderate groups regarding postoperative MRD1, correction success rates, or patient satisfaction. No major complications were reported.

Conclusions:

• The 4-step levator aponeurosis plication technique is equally effective for both mild and moderate congenital blepharoptosis.
• This modified technique achieves satisfactory functional and cosmetic correction while minimizing complications like residual lagophthalmos and depressed scars.