Transconjunctival levator muscle plication in mild to moderate congenital ptosis

Abstract

Purpose The aim of this study was to evaluate the efficacy, cosmetic result, and safety of transconjunctival plication of the levator muscle in the correction of simple congenital ptosis. Patients and methods This is a prospective interventional study that was performed on 23 eyelids (17 unilateral and three bilateral) of 20 patients with simple congenital ptosis and fair to good levator muscle function. All patients were subjected to transconjunctival levator plication. Preoperative history taking and ophthalmological examination were performed. Degree of ptosis was evaluated using the marginal reflex distance 1 (MRD1). Levator muscle function was evaluated using the Berke’s method. Serial follow-up was performed for all patients. Results The mean age of the patients was 6.65±3.13 years. Anatomical success (MRD1 of 3–5 mm and intereyelid difference of <1 mm) was achieved in 20 (86.96%) eyelids, whereas undercorrection occurred in three (13.04%) eyelids. A good cosmetic outcome was obtained in 21 (91.3%) eyelids. A statistically significant improvement was found between the preoperative MRD1 values and the 1- and 6-month postoperative values (P<0.001). There was no significant difference between MRD1 at 1 and 6 months, postoperatively (P=0.07). No major postoperative complications were reported. Conclusion Levator plication using the posterior transconjunctival approach is safe and effective for correcting simple congenital blepharoptosis with a good cosmetic outcome. This technique is especially useful for mild and moderate cases of congenital ptosis associated with good to fair levator muscle function.

Keywords

• congenital
• levator
• plication
• ptosis