Aponeurotic defects in congenital ptosis

Area of Science:

• Ophthalmology
• Surgical Anatomy

Background:

• Congenital ptosis is often idiopathic or due to levator muscle dystrophy.
• Levator aponeurosis disinsertion is a known cause of acquired ptosis.

Observation:

• Surgical exploration of 46 congenitally ptotic eyelids in 36 patients revealed levator aponeurosis disinsertion in three cases.
• These three cases had no history of birth trauma.

Findings:

• Levator aponeurosis disinsertion can be a cause of congenital ptosis.
• Aponeurotic repair was successful in all three identified cases of congenital levator disinsertion.

Implications:

• This finding expands the known etiologies of congenital ptosis.
• Preoperative identification methods for levator disinsertion in congenital ptosis are suggested.
• The aponeurotic approach may be suitable for congenital ptosis with adequate levator function (≥5 mm).