Determination of the Amount of Ptosis Correction in Levator Resection Surgery for Pediatric Congenital Ptosis

Abstract

Background

It is difficult to determine the amount of eyelid lift in levator resection surgery for congenital ptosis, especially when the surgery is performed under general anesthesia. We aim to introduce an objective and steady method with which to adjust eyelid height, and to identify other factors to be considered during surgery.

Methods

This is a retrospective, observational study of 110 eyes from 78 patients who underwent levator resection surgery for congenital ptosis. Postoperative eyelid height was observed chronologically. The amount of eyelid lift during surgery was compared with the real postoperative change of palpebral fissure width (PF). The factors influencing the postoperative changes in eyelid height were investigated to predict outcome.

Results

Postoperative eyelid height stabilized 1 month after surgery. The real postoperative change in PF was slightly larger than the amount of intraoperative eyelid lift in cases with levator muscle function (LF) ≥ 7 mm, whereas it tended to be smaller in cases with LF < 5 mm. Statistically significant factors influencing the difference between the amount of intraoperative eyelid lift and the real postoperative change of eyelid height included preoperative PF, preoperative LF, and anesthesia-induced lagophthalmos.

Conclusion

The preoperative PF, preoperative LF, and anesthesia-induced lagophthalmos should be considered when determining the amount of ptosis correction to perform in levator resection surgery.

Level of Evidence IV

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