title: A modified levine palpebral spring for the treatment of myogenic ptosis.
abstract: OBJECTIVE
  Surgical treatment of myogenic ptosis usually requires a form of frontalis suspension. Complications can include entropion, headache, contour abnormalities, and poor eyelid excursion. The Levine palpebral spring has been used successfully to augment eyelid closure in more than 2,000 patients. The authors present a modified Levine spring to correct ptosis in a patient with poor levator function.
  
  
  METHODS
  Interventional case report. A 55-year-old man with profound myogenic ptosis was treated with bilateral modified Levine palpebral springs. Eyelid position, contour and excursion, blink reflex, lagophthalmos, and ocular surface were evaluated.
  
  
  RESULTS
  The Levine palpebral spring functioned well to open both eyelids. Margin reflex distance improved from -3 mm to 3 m postoperatively. Excellent contour and excursion were observed. Orbicularis action, including blink reflex, was preserved, and ocular surface was not compromised.
  
  
  CONCLUSIONS
  The modified Levine palpebral spring is an alternative to frontalis suspension in treating select patients with eyelid ptosis with poor levator function.
authors.affiliation: Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts 02114 , USA. aaron_fay@meei.harvard.edu
authors.forename: Aaron
authors.initials: A
authors.lastname: Fay
authors.forename: Yvette Marie B
authors.initials: YM
authors.lastname: Santiago
mesh_terms: D000497:Alloys; D019882:Blepharoplasty / Q000295:instrumentation*; D001763:Blepharoptosis / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D011859:Radiography
chemical_list: D000497:Alloys