title: Analysis of visual outcomes and complications following levator resection for unilateral congenital blepharoptosis without strabismus.
abstract: BACKGROUND
  It is challenging to manage congenital blepharoptosis, especially unilateral, because symmetry is difficult to achieve under general anesthesia and age at which the ptosis should be corrected is still controversial. The aim of our study is to analyze visual and surgical outcomes after levator resection for unilateral congenital blepharoptosis.
  
  
  METHODS
  Charts of patients with unilateral congenital blepharoptosis who underwent levator resection at the Chang Gung Memorial Hospital from 1991 through 2000 were reviewed. The resultant database was interrogated for demographic data, severity, surgical timing, visual outcomes, surgical outcomes, and complications.
  
  
  RESULTS
  Eighty-four children underwent levator resection for unilateral congenital blepharoptosis: 16.7% of these patients had amblyopia and 84.5% had surgical success following levator resection. Severe ptosis (p = 0.0288, p < 0.05) and surgery at less than 2 years of age (p = 0.0126, p < 0.05) were the important factors contributing to surgical failure. Age at surgery (p = 0.0058, p < 0.01) and amblyogenic ametropia (p = 0.0001, p < 0.001) were found to be significantly associated with the postoperative visual results.
  
  
  CONCLUSIONS
  The levator resection provides satisfactory results both in function and cosmesis in patients with unilateral congenital blepharoptosis. Amblyogenic ametropia is the leading cause of amblyopia in the patients with unilateral isolated congenital blepharoptosis. However, patients with unilateral congenital blepharoptosis should have cycloplegic refraction as early as possible, and their visual status monitored until visual maturity.
authors.affiliation: Division of Orbital and Oculoplastic Surgery, Department of Ophthalmology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Shu-Ya
authors.initials: SY
authors.lastname: Wu
authors.forename: Lih
authors.initials: L
authors.lastname: Ma
authors.forename: Hsin-Hui
authors.initials: HH
authors.lastname: Huang
authors.forename: Yueh-Ju
authors.initials: YJ
authors.lastname: Tsai
mesh_terms: D000550:Amblyopia / Q000453:epidemiology; D001763:Blepharoptosis / Q000151:congenital* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009801:Oculomotor Muscles / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D017211:Treatment Failure