title: Outcomes of posterior-approach 'levatorpexy' in congenital ptosis repair.
abstract: OBJECTIVE
  We describe a minimally invasive technique and report our experience of posterior approach levator plication ('levatorpexy') for congenital ptosis.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Consecutive series of 16 patients.
  
  
  METHODS
  Posterior approach levatorpexy was performed for congenital ptosis under general anaesthesia. This surgical procedure involves exposing the posterior surface of the levator muscle through a transconjunctival approach. The levator muscle is advanced and plicated using a suture passed through its posterior surface, partial-thickness, to tarsal plate and tied on the skin. No tissue (conjunctiva, Muller's muscle, levator) are excised during this procedure.
  
  
  METHODS
  Data collected included margin reflex distance (MRD1), symmetry of eyelid height, contour and complications. Surgery was considered successful if the following three criteria were simultaneously met: A postoperative MRD1 of ≥2 mm and ≤4.5 mm, inter-eyelid height asymmetry of ≤1 mm, and satisfactory eyelid contour.
  
  
  RESULTS
  Mean age was 9.1 years (range 3-26 years). Mean postoperative follow-up was 8.1 months (4-24 months). Preoperative phenylephrine test was positive in 81% of patients. Mean levator function was 11 mm (5-15 mm). Mean preoperative MRD1 was 1.5 mm and the mean postoperative MRD1 was 2.6 mm. Fourteen patients (87%) achieved the desired eyelid height and fulfilled our criteria set for success.
  
  
  CONCLUSIONS
  Posterior approach levatorpexy appears to be a safe and effective procedure for correction of congenital ptosis particularly with moderate or better levator function.
authors.affiliation: Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, West Sussex, UK.
authors.forename: Zaid
authors.initials: Z
authors.lastname: Al-Abbadi
authors.affiliation: Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, West Sussex, UK.
authors.forename: Suresh
authors.initials: S
authors.lastname: Sagili
authors.affiliation: Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, West Sussex, UK.
authors.forename: Raman
authors.initials: R
authors.lastname: Malhotra
mesh_terms: D000293:Adolescent; D000328:Adult; D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000151:congenital / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005143:Eyelids / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D009801:Oculomotor Muscles / Q000601:surgery*; D010656:Phenylephrine; D012189:Retrospective Studies; D013536:Suture Techniques; D013566:Sympathomimetics; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D013566:Sympathomimetics; D010656:Phenylephrine
keywords: Eye Lids