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Small-incision levator resection for correction of congenital ptosis: a prospective study

  • Oculoplastics and Orbit
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To determine the rate of success of small-incision levator resection technique for correction of congenital ptosis.


Patients with congenital ptosis who were candidates for levator resection were enrolled if their levator function was not poor (< 5 mm). Incisions were made on upper eyelid crease with a length of 10–12 mm. After resection of adequate length of levator muscle, two sutures were used to fix it to tarsal plate. Sliding the incision to medial and lateral sides provided a wider field of access to allow the surgeon to place the sutures above nasal and temporal borders of limbus. Success was defined as margin reflex distance-1 (MRD-1) ≥ 3 mm and inter-eyelid difference of MRD-1 less than 1 mm, which was considered excellent if inter-eyelid difference was < 0.5 mm and good if the latter parameter was between 0.5 and 1 mm.


Fifty eyes of 47 congenital ptosis cases (16 males and 31 females) were included. Average age was 21.7 ± 9.7 years (range, 3–44 years). Mean preoperative levator function and MRD-1 were 11.26 ± 2.79 and 1.78 ± 0.92 mm, respectively, while postoperative MRD-1 increased to 3.95 ± 0.82 mm (P < 0.001). The result was failure (undercorrection) in 12 cases (25.5%), good in 9 patients (19.2%), and excellent in 26 cases (55.3%).


Small-incision levator resection has previously been studied for correction of aponeurotic ptosis and proved to yield successful outcome. The findings of this study suggest that small-incision technique can be effectively used in correction of congenital ptosis, as well.

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Correspondence to Hadi Ghadimi.

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The authors declare that they have no conflict of interest.

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All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Eshraghi, B., Ghadimi, H. Small-incision levator resection for correction of congenital ptosis: a prospective study. Graefes Arch Clin Exp Ophthalmol 256, 1747–1750 (2018).

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