[Effectiveness of transcutaneous levator resection in congenital ptosis of the upper lid]

Thirteen patients (15 eyes) were treated for simple congenital blepharoptosis by means of transcutaneous levator resection. The patients' ages ranged from 6 to 23 years, the postoperative follow-up period from 29 to 63 months. In 2 cases the operation was performed because of residual ptosis following transconjunctival levator resection. In 11 eyes the results were very good, with postoperative ptosis of between 0 and +/- 0.5 mm and complete lid closure. In 3 eyes the results were good, with ptosis between greater than + 0.5 mm and + 1.5 mm and complete lid closure; and there was one failure, with postsurgical ptosis of greater than + 1.5 mm. The major cosmetic defect in all cases was lid lag on extreme downward gaze. In view of these good results and the multiple advantages of the anterior transcutaneous levator resection procedure as compared to the posterior (conjunctival) approach, the authors feel able to claim that transcutaneous levator resection is the method of choice for most types of simple ptosis. The operation is extremely laborious but fully justified by the good results.