Outcomes of anterior levator resection in congenital blepharoptosis.

ABSTRACT

PURPOSE: To identify any consistent factors which may predict over- or undercorrection of congenital blepharoptosis treated by anterior levator resection. METHODS: A retrospective case note review of 100 consecutive patients undergoing anterior levator resection for congenital blepharoptosis was performed to identify (1) the amount of ptosis and degree of levator function present pre-operatively and (2) the surgical outcome. For unilateral ptosis, a successful result was defined as a lid level within 1 mm of the fellow lid following a single operation. RESULTS: Seventy-six per cent of all unilateral cases had a successful outcome at 6 weeks following surgery, falling slightly to 74% by 6 months. The most common complications at 6 months were undercorrection (19%) and overcorrection (7%). All patients undercorrected at 6 months had a pre-operative levator function in the range of 4-10 mm with a mean of 6.4 mm, whereas all those overcorrected at 6 months had a levator function in the range 9-15 mm with a mean of 12.2 mm. In the whole population, the degree of levator function was a predictor of increased risk of overcorrection, with a trend towards predicting undercorrection as well. CONCLUSIONS: In this series of patients, pre-operative levator function was found to be the most significant predictor of surgical outcome for anterior levator resection.