Abstract • In 68 consecutive patients with congenital blepharoptosis undergoing levator muscle resection, a formula derived from the preoperative margin limbal distance (MLD) was used to determine the amount of levator resection. Excellent results were achieved in 86% of 43 patients with unilateral blepharoptosis when this formula was followed. Of 25 patients with bilateral blepharoptosis, excellent results were achieved in 76% of eyelids. When compared with Berke's method, the MLD formula was superior in unilateral cases and almost equal in bilateral cases. The MLD formula gave the surgeon an excellent preoperative prediction of the amount of levator to resect and aided in the placement of the initial tarsal-levator suture. In unilateral cases, little if any tarsal-levator adjustment was necessary. In bilateral cases, Berke's intraoperative values enabled the surgeon to refine the MLD determination. References 1. Beard C: The surgical treatment of blepharoptosis: A quantitative approach . Trans Am Ophthalmol Soc 1966;64:401-487. 2. Smith B, McCord CD, Baylis H: Surgical treatment of blepharoptosis . Am J Ophthalmol 1969;68:92-99. 3. Berke RN: Congenital ptosis: A classification of 200 cases . Arch Ophthalmol 1949;41:188-197.Crossref 4. Berke RN, Wadsworth JAC: Histology of levator muscle in congenital and acquired ptosis . Arch Ophthalmol 1955;53:413-428.Crossref 5. Beard C: Ptosis , ed 3. St Louis, CV Mosby Co, 1981, pp 86-111, 158-162. 6. Berke RN: Results of resection of the levator muscle through a skin incision in congenital ptosis . Arch Ophthalmol 1959;61:177-201.Crossref 7. Putterman AM: Basic oculoplastic surgery , in Peyman GA, Sanders DR, Goldberg MF (eds): Principles and Practice of Ophthalmology . Philadelphia, WB Saunders Co, 1980, vol 3, pp 2247-2249. 8. Putterman AM, Urist M: Transconjunctival isolation and transcutaneous resection of the levator palpebrae superioris muscle . Am J Ophthalmol 1974;77:90-94. 9. Epstein GA, Putterman AM: Super-maximum levator resection for severe unilateral congenital blepharoptosis . Ophthalmic Surg 1984; 15:971-979.
Archives of Ophthalmology – American Medical Association
Published: Mar 1, 1985
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