Full-thickness eyelid resection in the treatment of secondary ptosis.
OBJECTIVE
To describe horizontal full-thickness eyelid resection for the treatment of ptosis as related to overcorrections after levator recession for eyelid retraction in Graves disease or repeatedly failed external levator advancement.


METHODS
The authors present a retrospective case study of 19 eyelids of 17 patients with refractory ptosis. Patients were selected based on history of horizontal full-thickness eyelid resection to treat ptosis secondary to over-recessed Müller and levator muscles, persistent ptosis after levator advancement/resection, or persistent ptosis after internal levator advancement. Results were graded from eyelid measurements taken before and at least 6 weeks after treatment.


RESULTS
All eyelids were measured preoperatively and postoperatively for the following parameters: palpebral fissure in primary gaze nasally (N), centrally (C), and temporally (T); upper eyelid margin to light reflex distance in primary gaze; upper eyelid margin to crease distance; and upper eyelid margin to fold distance. Final postoperative measurements were taken at a minimum of 2 months. Thirteen eyelids had a history of previous Müller muscle excision/levator recession, 3 eyelids had a history of previous levator advancement/resection, 2 eyelids had previous internal levator advancement, and 1 eyelid had previous cosmetic eyelid surgery. All 17 patients were women. Patients ranged in age from 41 to 63 years. All patients had cosmetically and functionally satisfactory results.


CONCLUSIONS
Horizontal full-thickness eyelid resection is a unique procedure that can provide an excellent result for patients with residual ptosis with no recurrence of ptosis during an average of 2 to 3 months follow-up.
Bassin
Roger E
RE
Department of Ophthalmology, University of Illinois-Chicago, Chicago, Illinois, USA.
Putterman
Allen M
AM
D000328:Adult; D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome