[Resection of the levator with transposition via Whitnall's ligament]

The paper deals with the treatment of severe congenital upper lid ptosis. In cases with the minimal mobility of the upper lid suspending operations are usually resorted to, those with suspending to Whitnall's ligament, among other things. Maximal resection of the levator muscle brought about encouraging results. The present paper describes the results of a modified operation: maximal resection of the levator with transposition of the muscle through Whitnall's ligament. A peculiar feature of surgical technique consists in preserving the intactness of the transverse ligament of the upper lid, crossing the lateral horns of the levator through the entire height, and transposition of the resected levator above Whitnall's ligament, this followed by suturing to the tarsal plate. The results of surgery were good. A better cosmetic and functional effect was attained than after common maximal resection of the levator; moreover, a lesser resection of the levator is needed in cases with the same degree of ptosis.