Levator-Muellers muscle resection through combined internal and external approach

ABSTRACT

This is a follow-up report on a modified ptosis procedure combining the merits of both the internal and external routes. The over-all rating of 92 success in this series appears to be better than in any series previously reported. The technique is discussed concisely, with emphasis in (1) the complete separation of the septum orbitale from the levator aponeurosis, (2) the care of the orbicularis during and after surgery, and (3) careful calculation of how much levator muscle to resect. This work bears out that sex and type of ptosis play an important role in the management of ptosis, more resection being required in females than in males and less resection in acquired ptosis than in congenital. The only complications to reckon with are lid edema, chemosis, and lagophthalmos; but these are only mild and not permanent. (Summary)