Ptosis repair by single suture aponeurotic tuck. Surgical technique and long-term results

To assess the effectiveness and long-term results of a simplified aponeurotic tuck technique for ptosis repair.

The author simplified the aponeurotic approach for ptosis repair by minimizing the dissection and using a single 6-0 nylon stitch to control the lid height and curvature. Prospectively, 169 ptotic lids were repaired by this technique over a 7-year period. All consecutive patients with ptosis ranging from 1 to 5 mm, levator function greater than 8 mm, and with no history of previous eyelid surgery were included. Patients with measurements and levator function outside of this range or who had ptosis secondary to eyelid or orbital mass, as a complication of eyelid surgery, or associated with systemic disease were excluded. The follow-up period ranged from 18 to 96 months, with an average of 60 months.

Of the 169 eyelids, 162 (95%) were corrected to 1 mm. There were 12 reoperations, including 4 on patients who had initial correction to within 1 mm. Complications included overcorrection in three patients and undercorrection in six, peaking in five, and two immediate recurrences and three late recurrences. Long-term results were excellent, as no change in the lid height was observed.

The single-stitch aponeurotic tuck is simple, effective, and versatile. It can be used in the correction of involutional, postcataract, traumatic, and congenital types of ptosis. Although local anesthesia is preferred, consistent results also can be obtained in those cases where general anesthesia is indicated. The complications that occurred were minimal and easily corrected.