title: The modified fasanella-servat procedure:  description and quantified analysis.
abstract: OBJECTIVE
  To describe a modified Fasanella-Servat procedure and nomogram for the correction of minimal amounts of ptosis.
  
  
  METHODS
  Retrospective review of this modified Fasanella-Servat procedure was performed on 118 eyelids in 86 consecutive patients over 2, 4-year periods by 1 surgeon (S.C.D.). The amount of tarsectomy was based on the amount of ptosis.
  
  
  RESULTS
  Mean pre- and postoperative margin-to-reflex distance 1 were +0.7 mm and +2.4mm, respectively. One hundred and twelve eyelids (95%) had satisfactory results with postoperative margin-to-reflex distance 1 ≥ 1.5 mm. Eyelid symmetry was achieved in 92% of eyelids to within 0.5 mm. There was no incidence of overcorrection, tarsal buckling, or corneal abrasion. One eyelid had a contour deficit. Tarsectomy amount ranged from 2 mm to 5 mm. Average amount of tarsectomy to eyelid elevation was 2.4:1.
  
  
  CONCLUSIONS
  The modified Fasanella-Servat procedure is technically easy, time-efficient, and has a low complication rate for the treatment of minimal blepharoptosis (< 2.5 mm) with good levator function and negative phenylephrine test. In the authors' hands, the ratio of tarsectomy to eyelid elevation is approximately 2:1. In addition to other techniques such as levator advancement and Müller's muscle conjunctival resection, the modified Fasanella-Servat technique is a useful adjunct to the modern ptosis surgeon's armamentarium.
authors.affiliation: Eyesthetica, Oculofacial and Cosmetic Surgery Associates, University of Southern California, Los Angeles, CA 90403-5743, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Samimi
authors.forename: Melanie H
authors.initials: MH
authors.lastname: Erb
authors.forename: Christianne J
authors.initials: CJ
authors.lastname: Lane
authors.forename: Steven C
authors.initials: SC
authors.lastname: Dresner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001763:Blepharoptosis / Q000601:surgery*; D001767:Blinking; D002648:Child; D002675:Child, Preschool; D005143:Eyelids / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D049451:Nomograms; D013508:Ophthalmologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult